Antithrombotic therapy for pregnancy complications: let's not throw the baby out with the bath water.

Context Placenta-mediated pregnancy complications, ranging from miscarriage to growth restriction and pre-eclampsia, collectively affect more than 25% of pregnancies. While the aetiology of pregnancy complications is heterogeneous, it is plausible that common processes such as inflammation and activation of the coagulation system play key roles. Therefore, antithrombotic treatments, specifically low-dose aspirin (LDA) and low molecular-weight heparin (LMWH), have been used for these conditions, usually following the diagnosis of pregnancy. There are biological data indicating that LDA can improve endometrial growth and vascularisation in women undergoing assisted conception, suggesting that treatment-initiated preconception could influence pregnancy outcomes. There is limited information on preconceptional use of such agents. The Effects of Aspirin in Gestation and Reproduction (EAGeR) study examined the effects on live birth rate of LDA started preconceptionally in women with previous pregnancy loss.