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Neonatal thrombosis.

R Saxena1, M Kannan, V P Choudhry

  • 1Department of Hematology, All India Institute of Medical Sciences, New Delhi, Ansari Nagar, India. renusax@hotmail.com

Indian Journal of Pediatrics
|January 2, 2004
PubMed
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Neonatal thrombosis, often linked to central lines, poses significant risks. Laboratory tests identify hypercoagulable states, but the role of genetic defects in infant blood clots remains unclear.

Area of Science:

  • Neonatal Medicine
  • Hematology
  • Pediatric Thrombosis

Background:

  • Neonatal thrombosis is a critical condition leading to mortality and severe disability.
  • Central venous catheterization is the primary risk factor, affecting commonly cannulated vessels.
  • Other risk factors include asphyxia, septicemia, dehydration, maternal diabetes, and cardiac disease.

Purpose of the Study:

  • To review the risk factors and diagnostic laboratory findings associated with neonatal thrombosis.
  • To discuss the potential, though uncertain, role of inherited thrombotic gene defects in neonates.

Main Methods:

  • Literature review of neonatal thrombosis risk factors and diagnostic markers.
  • Analysis of laboratory findings indicative of hypercoagulable states.

Related Experiment Videos

  • Discussion of genetic prothrombotic defects (e.g., Factor V Leiden) in the context of neonatal cases.

    • Main Results:

    • Central lines are the most significant risk factor for neonatal thrombosis.
    • Diagnostic laboratory findings include shortened aPTT, reduced inhibitors (AT III, Protein C, Protein S), APC resistance, and defective fibrinolysis.
    • Increased clotting factors, hyperactive platelets, elevated viscosity, and antiphospholipid antibodies are also noted.
    • Prothrombotic gene defects like FV Leiden, P20210, and MTHFR are present in Caucasian populations but their causative role in neonates is undetermined.

    Conclusions:

    • Neonatal thrombosis is multifactorial, with central lines being a major contributor.
    • A range of laboratory abnormalities can indicate a hypercoagulable state in neonates.
    • The precise contribution of common genetic prothrombotic mutations to neonatal thrombosis requires further investigation.