Coumarins during Pregnancy: Long-term Effects on Growth and Development of School-age Children

J. Wesseling; D. Van Driel; H. S. A. Heymans; F. R. Rosendaal; L. M. Geven-Boere; M. Smrkovsky; B. C. L. Touwen; P. J. J. Sauer; E.Van der Veer

doi:10.1055/s-0037-1615641

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2001; 85(04): 609-613
DOI: 10.1055/s-0037-1615641

Review Articles

Schattauer GmbH

Coumarins during Pregnancy: Long-term Effects on Growth and Development of School-age Children

J. Wesseling

¹Department of Paediatrics, Beatrix Children’s Hospital, University Hospital Groningen

,

D. Van Driel

¹Department of Paediatrics, Beatrix Children’s Hospital, University Hospital Groningen

,

H. S. A. Heymans

²Department of Paediatrics, Emma Children’s Hospital, Academic Medical Center, Amsterdam

,

F. R. Rosendaal

³Department of Clinical Epidemiology, Leiden University Medical Center, Leiden

,

L. M. Geven-Boere

⁴Dutch Federation of Thrombosis Services, The Hague

,

M. Smrkovsky

⁵Department of Special Education, University of Groningen

,

B. C. L. Touwen

⁶Department of Medical Physiology, Developmental Neurology Section, University of Groningen

,

P. J. J. Sauer

¹Department of Paediatrics, Beatrix Children’s Hospital, University Hospital Groningen

,

E.Van der Veer

⁷Pathology & Laboratory Medicine, University Hospital Groningen, The Netherlands

› Author Affiliations

Abstract

Summary

Anticoagulation during pregnancy is complicated because of potential risks for mother and foetus. Unfractionated or low-molecular-weight heparin is used for most anticoagulant indications. Its efficacy, however, in pregnant women with prosthetic heart valves is questioned, therefore coumarins are preferred for this indication.

We studied long-term effects of prenatal coumarin-exposure on growth and on neurological, behavioural and cognitive development in 274 school-age children in comparison with 231 age-matched non-exposed controls. No major abnormalities were found. The exposed children had an increased risk for minor neurological dysfunction and for a low intelligence quotient (IQ below 80). The risk for a combination of two or more (minor) abnormalities was higher for the exposed children, RR = 7.6. We conclude that prenatal exposure to coumarins is associated with an increased risk for disturbances in development in school-age children. However, for the vast majority of children there is no clinical significant effect on growth and long-term development.

Keywords

Anticoagulants - long-term effect - growth - behaviour - neurological development - intelligence

Full Text

References

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