Venous thromboembolic (VTE) disease is a major cause of morbidity and mortality during pregnancy and the puerperium. Enoxaparin, a low molecular weight heparin (LMWH), is standard of care for the management of VTE risk in pregnancy, after individualized benefit–risk assessment. This systematic review and meta-analysis demonstrate the safety of enoxaparin in pregnancy.

Though reports of thromboembolic events, thrombocytopenia, and teratogenicity were rare, enoxaparin use during pregnancy was associated with lower occurrence of pregnancy loss when compared with controls and similar rates of bleeding.

Both real-world studies and clinical trials were assessed in this analysis, and, in light of the adoption of antenatal LMWH in clinical practice, real-world data and continued safety reporting will help further inform future treatment guidelines surrounding this important topic.