Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan;22(1):126-139.
doi: 10.1016/j.jtha.2023.09.021. Epub 2023 Sep 30.

Desmopressin to prevent and treat bleeding in pregnant women with an inherited bleeding disorder: a systematic literature review

Wala Al Arashi  1 , Lorenzo G R Romano  2 , Frank W G Leebeek  2 , Marieke J H A Kruip  2 , Karin P M van Galen  3 , Ozlem Turan  4 , Rezan Abdul Kadir  4 , Marjon H Cnossen  5 ; SYMPHONY consortium
Affiliations
Free article

Desmopressin to prevent and treat bleeding in pregnant women with an inherited bleeding disorder: a systematic literature review

Wala Al Arashi et al. J Thromb Haemost. 2024 Jan.
Free article

Abstract

Background: Although desmopressin (DDAVP) is an accessible and inexpensive hemostatic drug, its use in pregnancy is still debated due to safety uncertainties.

Objectives: We aimed to review the safety and effectiveness of DDAVP in women with an inherited bleeding disorder during pregnancy and delivery.

Methods: Databases were searched for articles up to July 25, 2022, reporting maternal and/or neonatal outcomes. PRISMA methodology for systematic reviews and meta-analyses was followed (PROSPERO CRD42022316490).

Results: Fifty-three studies were included, comprising 273 pregnancies. Regarding maternal outcomes, DDAVP was administered in 73 women during pregnancy and in 232 during delivery. Safety outcome was reported in 245 pregnancies, with severe adverse events reported in 2 (1%, hyponatremia with neurologic symptoms). Overall, DDAVP was used as monotherapy in 234 pregnancies, with effectiveness reported in 153 pregnancies (82% effective; 18% ineffective). Regarding neonatal outcomes, out of 60 pregnancies with reported neonatal outcomes after DDAVP use during pregnancy, 2 children (3%) had a severe adverse event (preterm delivery n = 1; fetal growth restriction n = 1). Of the 232 deliveries, 169 neonates were exposed to DDAVP during delivery, and in 114 neonates, safety outcome was reported. Two children (2%) experienced a moderate adverse event (low Apgar score n = 1; transient hyperbilirubinemia not associated with DDAVP n = 1).

Conclusion: DDAVP use during pregnancy and delivery seems safe for the mother, with special attention to the occurrence of hyponatremia and for the child, especially during delivery. However, due to poor study designs and limited documentation of outcomes, a well-designed prospective study is warranted.

Keywords: blood coagulation disorders, inherited; desmopressin; outcomes, maternal; outcomes, neonatal; pregnancy; review, systematic.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interests L.G.R.R. received a travel grant in 2019 as well as the Young Investigators Award in 2020, both from Sobi. F.W.G.L. has received unrestricted research grants from CSL Behring, Takeda, Sobi, and uniQure; is a consultant for CSL Behring, Takeda, Biomarin, and uniQure, of which the fees go to the University; and was a Data and Safety Monitoring Board (DSMB) Guidelines | National Institute of Dental and Craniofacial Research (nih.gov) member of a study sponsored by Roche. M.J.H.A.K. received funding for research outside this project from Sobi and speaker fees from Roche, Sobi, and BMS; all payments (funding and speakers fee) were made to the institute (Erasmus MC). M.H.C. has received investigator-initiated research and travel grants over the years from the Netherlands Organization for Scientific Research, the Netherlands Organization for Health Research and Development, the Dutch “Innovatiefonds Zorgverzekeraars,” Pfizer, Baxter/Baxalta/Shire, Bayer Schering Pharma, CSL Behring, Sobi, Novo Nordisk, Novartis, and Nordic Pharma, and has served as a steering board member for Roche and Bayer. All grants, awards, and fees go to the institution. The other authors declare no conflicts of interest relevant to the contents of this manuscript. This study was performed on behalf of the SYMPHONY consortium (NWA.1160.18.038.) which is funded by a grant from the Netherlands Organization for Scientific Research.

Publication types

LinkOut - more resources