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Purpose <p>This study aimed to evaluate the impact of unfractionated heparin (UFH) use during pregnancy on maternal bone mineral density (BMD) by assessing BMD in pregnant women with heparin exposure using an artificial intelligence (AI)-assisted analysis of chest radiographs.</p> Methods <p>This retrospective cohort study was conducted between April 2013 and October 2023. Pregnant women who received UFH therapy and underwent cesarean section (CS) were compared, using preoperative chest radiographs, with a control group who underwent CS without medication. Estimated BMD (eBMD) values for the lumbar spine (LS) and femoral neck (FN) were obtained via an AI-assisted diagnostic system. Statistical analyses included univariate and multivariate methods, adjusted for covariates.</p> Results <p>Compared with the control group (n = 213), the UFH group (n = 86) exhibited significantly lower eBMD values at both LS and FN. Body mass index (BMI) correlated with eBMD in both groups, with underweight participants showing significantly lower eBMD, particularly in the UFH group. Multivariate analysis identified UFH as an independent factor associated with reduced eBMD in patients with LS. No significant correlation was found between the total UFH dose and eBMD.</p> Conclusion <p>UFH administration during pregnancy may be associated with decreased maternal eBMD, especially in underweight women, with the LS appearing more susceptible to bone loss than the FN. The estimation system may provide a safe, accessible, and effective method for early detection and risk stratification of pregnancy-associated bone loss, supporting future clinical management in at-risk populations.</p>

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Impact of Unfractionated Heparin Use on Maternal Bone Mineral Density During Pregnancy: A Retrospective Study Using AI-Assisted Radiographic Analysis

  • 期刊论文

  • 发表日期：

    2026年5月28日

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  • Yuki Enomoto,
  • Osamu Wada-Hiraike,
  • Toru Moro,
  • Junya Furuki,
  • Maika Nariai,
  • Hiromi Ga,
  • Risa Takai,
  • Maho Furukawa,
  • Saki Tsuchimochi,
  • Noriko Yoshimura,
  • Sakae Tanaka,
  • Yasushi Hirota

摘要

Purpose

This study aimed to evaluate the impact of unfractionated heparin (UFH) use during pregnancy on maternal bone mineral density (BMD) by assessing BMD in pregnant women with heparin exposure using an artificial intelligence (AI)-assisted analysis of chest radiographs.

Methods

This retrospective cohort study was conducted between April 2013 and October 2023. Pregnant women who received UFH therapy and underwent cesarean section (CS) were compared, using preoperative chest radiographs, with a control group who underwent CS without medication. Estimated BMD (eBMD) values for the lumbar spine (LS) and femoral neck (FN) were obtained via an AI-assisted diagnostic system. Statistical analyses included univariate and multivariate methods, adjusted for covariates.

Results

Compared with the control group (n = 213), the UFH group (n = 86) exhibited significantly lower eBMD values at both LS and FN. Body mass index (BMI) correlated with eBMD in both groups, with underweight participants showing significantly lower eBMD, particularly in the UFH group. Multivariate analysis identified UFH as an independent factor associated with reduced eBMD in patients with LS. No significant correlation was found between the total UFH dose and eBMD.

Conclusion

UFH administration during pregnancy may be associated with decreased maternal eBMD, especially in underweight women, with the LS appearing more susceptible to bone loss than the FN. The estimation system may provide a safe, accessible, and effective method for early detection and risk stratification of pregnancy-associated bone loss, supporting future clinical management in at-risk populations.