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Finding adverse
Therapeutic heparin use during pregnancy in women with Fontan physiology was significantly associated with bleeding events compared to no antithrombotic therapy (OR 15.6, 95% CI 1.88-129, p=0.006).
Effect sizeOR 15.6
CI95% CI 1.88 to 129
ComparatorNo antiplatelet or anticoagulation therapy
Effect summaryadverse; OR 15.6; CI: 95% CI 1.88 to 129
Adverse eventsbleeding events 15.6% (OR 15.6)
Effect modifiers[{"modifier": "thrombotic risk category (high vs low)", "interaction_p": "p=0.038", "direction": "amplifies", "stratum_details": "High thrombotic risk (>=2 risk factors): OR 2.49 (95% CI 1.05-5.89, p=0.038) for bleeding; these patients more likely to be on therapeutic ACM", "plain_language": "Women who were already at high risk for blood clots also had a higher risk of bleeding, and they were more likely to be on the stronger blood thinners that cause bleeding.", "annotation_notes": "High risk defined as >=2 of: prior arrhythmia, prior stroke/TIA, history of VTE, cyanosis, LVEF <40%, atrio-pulmonary connection"}, {"modifier": "trimester", "interaction_p": "p=0.025", "direction": "amplifies", "stratum_details": "Second trimester: OR 1.27 (95% CI 0.436-3.69, p=0.62, NS); Third trimester: OR 3.3 (95% CI 1.39-9.63, p=0.025)", "plain_language": "Bleeding risk doubled in the third trimester compared to the first, and this was also the most common time for bleeding events.", "annotation_notes": "Third trimester was most common time for a bleeding event (47.6% of all bleeding events)"}]

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Source

PMC10367127
Bleeding and thrombotic risk in pregnant women with Fontan physiology
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