Neonatal haemostasis. Impact on bleeding and thrombosis

Area of Science:

• Pediatric Hematology
• Neonatal Coagulation and Fibrinolysis
• Hemostasis in Early Life

Background:

• The human coagulation system undergoes significant maturation postnatally, leading to distinct hemostasis profiles in neonates and young children compared to adults.
• Despite developmental differences, the neonatal hemostasis system is functionally balanced, with healthy neonates exhibiting no increased bleeding or thrombotic tendencies.
• Systemic diseases can disrupt this balance, increasing the risk of hemorrhagic or thrombotic complications in neonates.

Purpose of the Study:

• To highlight the age-related differences in coagulation and fibrinolysis between neonates, young children, and adults.
• To emphasize the functional balance of the neonatal hemostasis system in healthy infants.
• To underscore the increased thrombotic risk in hospitalized neonates, particularly those with central venous catheters.

Main Methods:

• Review of existing literature on neonatal and pediatric coagulation and fibrinolysis.
• Analysis of hemostasis differences in relation to age and clinical conditions.
• Examination of risk factors for hemorrhagic and thrombotic complications in neonates.

Main Results:

• Neonates and young children possess unique coagulation and fibrinolysis characteristics compared to older individuals.
• Healthy neonates demonstrate a balanced hemostatic system, not prone to spontaneous bleeding or thrombosis.
• Hospitalized neonates, especially those with central venous catheters, exhibit a higher incidence of thrombosis.

Conclusions:

• Accurate diagnosis of hemostasis disorders in pediatric populations necessitates age-specific, analyzer-appropriate, and reagent-specific reference ranges.
• Management of hemostatic disorders in neonates requires adherence to age-specific guidelines.
• Understanding age-related hemostatic differences is crucial for managing neonatal bleeding and thrombotic risks.