Clinical Data of Neonatal Systemic Thrombosis

Paola Saracco, Rossana Bagna, Chiara Gentilomo, Mariella Magarotto, Alice Viano, Federica Magnetti, Paola Giordano, Matteo Luciani, Angelo Claudio Molinari, Agnese Suppiej, Luca Antonio Ramenghi, Paolo Simioni, Neonatal Working Group of the Registro Italiano Trombosi Infantili (RITI)

Research output: Contribution to journalArticle

Abstract

Objective To evaluate clinical data and associated risk conditions of noncerebral systemic venous thromboembolism (VT), arterial thromboembolism (AT), and intracardiac thromboembolism (ICT) in neonates. Study design Data analysis of first systemic thromboembolism occurring in 75 live neonates (0-28 days), enrolled in the Italian Registry of Pediatric Thrombosis from neonatology centers between January 2007 and July 2013. Results Among 75 events, 41 (55%) were VT, 22 (29%) AT, and 12 (16%) ICT; males represented 65%, and 71% were preterm. In 19 (25%), thromboembolism was diagnosed on the first day of life. In this "early onset" group, prenatal-associated risk conditions (maternal/placental disease) were reported in 70% and inherited thrombophilia in 33%. Postnatal risk factors were present in 73%; infections and central vascular catheters in 56% and 54% VT, respectively, and in 67% ICT vs 27% AT (<.05). Overall mortality rate was 15% and significant thromboembolism-related sequelae were reported in 16% of discharged patients. Conclusions This report from the Registro Italiano Trombosi Infantili, although limited by representing an uncontrolled case series, can be used to develop future clinical trials on appropriate management and prevention of neonatal thrombosis, focusing on obstetrical surveillance and monitoring of critically ill neonates with vascular access. A thrombosis risk prediction rule specific for the neonatal population should be developed through prospective controlled studies.

Original languageEnglish
Pages (from-to)60-66e1
JournalJournal of Pediatrics
Volume171
DOIs
Publication statusPublished - Apr 1 2016

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Medicine(all)

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    Saracco, P., Bagna, R., Gentilomo, C., Magarotto, M., Viano, A., Magnetti, F., Giordano, P., Luciani, M., Molinari, A. C., Suppiej, A., Ramenghi, L. A., Simioni, P., & Neonatal Working Group of the Registro Italiano Trombosi Infantili (RITI) (2016). Clinical Data of Neonatal Systemic Thrombosis. Journal of Pediatrics, 171, 60-66e1. https://doi.org/10.1016/j.jpeds.2015.12.035