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Volume 353:1975 November 3, 2005 Number 18
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Screening for Osteoporosis

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by Raisz, L. G.
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To the Editor: Raisz (July 14 issue)1 does not discuss a common risk factor for osteoporosis: long-term heparin administration during pregnancy. There are a number of preexisting indications (such as a history of deep-vein thrombosis) or contemporaneous indications (such as some thrombophilias or the presence of antiphospholipid antibodies with recurrent pregnancy loss) for low-dose or adjusted-dose heparin prophylaxis to be given throughout pregnancy.2 There are also conventional indications for treatment, such as new-onset deep-vein thrombosis during pregnancy. To obviate heparin-associated osteoporosis, the use of one of the low-molecular-weight heparins, calcium and vitamin D supplementation, and weight-bearing exercise are recommended.3,4


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