Table 1.

Summary of safety of anticoagulant use in pregnancy and during breastfeeding

AnticoagulantSafe duringpregnancySafe duringbreastfeedingEvidence-based summary
Heparins Yes Yes Does not cross the placenta; extensive safety data from observational studies 
VKAs No Yes Crosses the placenta; may cause coumadin embryopathy (if used between 6th and 12th week), fetal bleeding, and neurodevelopmental deficits 
DOACs No No Crosses the placenta; reproductive effects unknown 
Danaparoid Yes Yes Does not cross the placenta 
Fondaparinux Probably yes Yes Crosses the placenta to some extent; limited data suggest it is safe for the fetus 
AnticoagulantSafe duringpregnancySafe duringbreastfeedingEvidence-based summary
Heparins Yes Yes Does not cross the placenta; extensive safety data from observational studies 
VKAs No Yes Crosses the placenta; may cause coumadin embryopathy (if used between 6th and 12th week), fetal bleeding, and neurodevelopmental deficits 
DOACs No No Crosses the placenta; reproductive effects unknown 
Danaparoid Yes Yes Does not cross the placenta 
Fondaparinux Probably yes Yes Crosses the placenta to some extent; limited data suggest it is safe for the fetus 

Data adapted.15 

DOAC, direct oral anticoagulant; VKA, vitamin K antagonist.

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