Category: Federal Forum Posters
Purpose: Gestation is associated with a hypercoagulable state due to the increase in the production of clotting factors. Pregnant females are at risk of thrombotic complications, which increases the risk of morbidity and mortality for both the fetus and the mother. The use of anti-thrombotic and anti-platelet agents during pregnancy is increasing. The objective of this study was to examine the prevalence and determinants of anti-platelet and anti-thrombotic medications use during gestation among Lebanese pregnant women.
Methods: A prospective, cross-sectional, multi-center study was conducted between December 2018 and May 2019 in pregnant females from the three districts of Lebanon: Beirut (the capital of Lebanon), South, and Mount Lebanon. The study was conducted in different gynecology clinics after receiving the gynecologist approval. The clinics were selected using cluster sampling. The participants enrolled in the study received an informed consent and were interviewed by a registered pharmacist. The pregnant females were asked to complete a questionnaire regarding their demographics, pregnancy state, and the use of anti-thrombotic and anti-platelet medications. The name of the medication was documented with the dose and frequency of administration, in addition to the indication of anti-thrombotic agent use. The main outcome was assess the frequency of anti-thrombotic and anti-platelet use drug pregnancy. Statistics were analyzed using statistical Package for Social Sciences version 25. Statistical tests used were frequency chi-square and logistic regression. P-value less than 0.05 was considered significant.
Results: Of 368 Lebanese pregnant females interviewed, 102 (27%) females used either anti-thrombotic or anti-platelet medications. Of these, 6.8% were from Beirut region and 20% were from South. Of those receiving anti-platelet and anti-thrombotic drugs, the most common drug prescribed was Acetylsalicylic acid at a dose of 81 mg (88.2%) followed by Tinzaparin (10%) at a dose of 3500 IU and 1.9% at a dose of 4500 IU then Enoxaparin (1%) (P-value < 0.05). The major indication for the use of anti-thrombotic and anti-platelet medication was previous abortion (44%), followed by thrombosis (22%), then infertility (11%) and (5%) was due to other causes.
Conclusion: Gestation is a period of increased risk for thrombotic events. A large proportion of pregnant women in the Lebanese population received anti-thrombotic medications. The latter suggests a trend in prescribing practices with potentially important implications for mothers, and their neonate. Monitoring of prescribing practices and balance between risks and benefits to mother and fetus should be assessed before the prescription of anticoagulants and anti-platelet agents in pregnancy.