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Outcomes in infants with unprovoked venous thromboembolism: A retrospective cohort study

Hilary Whitworth1, Lauren A Beslow2, Rebecca A Hubbard3

  • 1Division of Hematology, Children's Hospital of Philadelphia, Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Research and Practice in Thrombosis and Haemostasis
|August 4, 2023
PubMed

Insights

Infants with unprovoked venous thromboembolism (VTE) have a low recurrence rate but face significant long-term risks of organ damage, including neurological and kidney issues.

Area of Science:

  • Pediatric Thrombosis Research
  • Neonatal and Infant Health Outcomes
  • Vascular Medicine

Background:

  • Infants under 1 year have a higher venous thromboembolism (VTE) rate than older children.
  • Unprovoked VTE in this age group is rare, with limited data on recurrence and long-term consequences.
  • Most infant VTE cases are associated with additional prothrombotic risk factors.

Purpose of the Study:

  • To determine the recurrence rate of unprovoked VTE in infants.
  • To evaluate long-term end-organ outcomes in infants with intracranial and renal vein thrombosis.
  • To assess anticoagulation duration and outcomes in this pediatric population.

Main Methods:

  • Retrospective cohort study of infants (<1 year) with unprovoked VTE (2003-2021).
  • Kaplan-Meier analysis for time to recurrence and anticoagulation duration.
  • Assessment of neurologic outcomes using the pediatric stroke outcome measure.
  • Evaluation of kidney function using estimated glomerular filtration rates.

Main Results:

  • Forty infants with VTE (intracranial, renal, portal, extremity) were followed for a median of 4.7 years.
  • One recurrent VTE event occurred over 237 person-years (incidence rate: 4 per 1000 person-years).
  • 40% of infants with intracranial thrombosis had moderate/severe neurologic outcomes; two-thirds with renal vein thrombosis had abnormal kidney function.

Conclusions:

  • Infants with unprovoked VTE exhibit a low risk of recurrence.
  • Significant end-organ morbidity, particularly neurological and renal complications, is observed in this cohort.
  • Long-term monitoring is crucial for infants experiencing unprovoked VTE.
Abstract

Keywords:
infantnewbornpediatricsthrombosisvenous thromboembolism

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