AUTHOR=Zhao Peng , Lu Yicheng , Liu Sitong , Zhang Lidan , Chen Chong , Yang Xiaofu TITLE=Evaluating the efficacy of low-molecular-weight heparin in managing umbilical artery thrombosis during pregnancy: does it offer therapeutic benefits? JOURNAL=Frontiers in Medicine VOLUME=Volume 12 - 2025 YEAR=2025 URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1540685 DOI=10.3389/fmed.2025.1540685 ISSN=2296-858X ABSTRACT=IntroductionUmbilical artery thrombosis (UAT) is a rare but serious pregnancy complication, potentially causing fetal growth restriction, distress, and stillbirth. Diagnosis relies on Doppler ultrasound and pathological assessment. Close monitoring and potential low-molecular-weight heparin (LMWH) therapy aim to prolong gestation and improve outcomes, but debate persists on its efficacy compared to expectant management.MethodsA retrospective study, conducted between January 2013 and December 2023, enrolled singleton pregnant women diagnosed with UAT during pregnancy. The experiment group included pregnant women who underwent LMWH with anti-coagulation therapy during pregnancy, while the expectant group comprised pregnancies that received standard prenatal care without any specific intervention for UAT.ResultsThe expectant group showed a significant increase in birth weight (expectant vs. experiment: 2434.40 ± 770.20 g vs. 1874.46 ± 717.83 g, P < 0.05) and a significant decrease in the incidence of births before 34 weeks (expectant vs. experiment: 42.24% vs. 82.75%, P < 0.05). Gestational age at birth was notably higher in the expectant group as compared to the experiment group (35.32 ± 3.89 vs. 33.59 ± 4.17), although the difference did not reach statistical significance (p = 0.110). The multi-factor ANOVA revealed statistically significant effects of anti-coagulation therapy (F = 4.479, p = 0.039) and gestational age at birth (F = 179.110, p = 0.000) on birth weight. This study found that the relationship between these variables can be formulated as: birth weight = −3314.782–256.106 × anti-coagulation therapy (coded as 1 if yes and 0 if no) +161.858 × gestational age at birth.ConclusionOur study suggests that expectant therapy may offer substantial benefits compared to experimental therapy involving the administration of LMWH.