Thromb Haemost 2001; 85(04): 609-613
DOI: 10.1055/s-0037-1615641
Review Articles
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Coumarins during Pregnancy: Long-term Effects on Growth and Development of School-age Children

J. Wesseling
1  Department of Paediatrics, Beatrix Children’s Hospital, University Hospital Groningen
,
D. Van Driel
1  Department of Paediatrics, Beatrix Children’s Hospital, University Hospital Groningen
,
H. S. A. Heymans
2  Department of Paediatrics, Emma Children’s Hospital, Academic Medical Center, Amsterdam
,
F. R. Rosendaal
3  Department of Clinical Epidemiology, Leiden University Medical Center, Leiden
,
L. M. Geven-Boere
4  Dutch Federation of Thrombosis Services, The Hague
,
M. Smrkovsky
5  Department of Special Education, University of Groningen
,
B. C. L. Touwen
6  Department of Medical Physiology, Developmental Neurology Section, University of Groningen
,
P. J. J. Sauer
1  Department of Paediatrics, Beatrix Children’s Hospital, University Hospital Groningen
,
E.Van der Veer
7  Pathology & Laboratory Medicine, University Hospital Groningen, The Netherlands
› Author Affiliations
Further Information

Publication History

Received 25 May 2000

Accepted after resubmission 06 November 2000

Publication Date:
08 December 2017 (online)

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.