Antithrombin improves fetal condition in women with severe pre-eclampsia before 32 weeks of gestation; a randomized, double-blind, placebo-controlled trial.

AIM: To see if antithrombin (AT) supplementation improved fetal outcomes in early onset (<32 weeks) severe pre-eclampsia.

METHODS

A subgroup re-analysis of an original randomized controlled trial of AT in pre-eclampsia between 24 and 35 weeks of gestation was performed. Either AT (3000 IU/day, n=42) or placebo (Albumin 582 mg/day, n=42) were administered for 7 days. Fetal weight gain, biophysical profile score and fetal heart rate monitoring were evaluated during the treatment week and until delivery. Comparisons were performed by intent-to-treat and relative risk (RR) and 95% Confidence Intervals (CI) were obtained.

RESULTS

In each group, 27 women (64%) completed the allocated intervention. AT significantly decreased the worsening of the fetal biophysical profile score or fetal heart rate monitoring (RR 0.24, 95% CI 0.07-0.8), increased the incidence of estimated weight gain >15 g/day during the intervention week (3.1, 1.0-9.9), and prolonged gestational age to >or= 34 weeks (3.6, 1.05-12.6), however infant mortality rates did not differ between the two groups. No adverse events related to AT were observed.

CONCLUSIONS

Supplementation of AT preserves fetal biophysical condition and weight gain in early onset severe pre-eclampsia and most likely prolongs pregnancies >or= 34 weeks of gestation.