Abstract
Thrombosis is the result of congenital or acquired prothrombotic risk factors. The incidence of thrombosis in the paediatric population is highest in newborns, as about 10% of thrombotic events occur in the first four weeks of life. Haemostasis in a newborn, though still developing, is a well balanced mechanism. About 90% of all thrombotic events are due to acquired and the rest to congenital risk factors. The aim of our study was to estimate the incidence of thrombosis in a population of Slovenian newborns and to study risk factors, location and treatment of thrombotic events. Inpatient charts of newborns with thrombosis, admitted to a tertiary neonatology centre and paediatric intensive care unit between 2004 and 2011, were studied retrospectively. Family history, location, aetiology and treatment of thrombosis were analysed. Thirty one newborns, 17 boys (54.8%) and 14 girls (45.2%), with 31 thrombotic events were found. There were 17 cases (54.8%) of arterial and 14 cases (45.2%) of venous thrombosis. A family history of thrombophilia was found in two cases (6.5%). Twenty six cases (83.9%) were contributed to acquired risk factors and five (16.1%) to congenital aetiology. Four cases (12.8%) were treated, two with anticoagulation, one with thrombolysis and one with both. The estimated incidence of thrombosis was 0.17 per 1000 live births. Our data showed a higher incidence of thrombosis in Slovenian newborns and a higher incidence of congenital prothrombotic risk factors than in the data published so far.
Highlights
Neonatal haemostasis is a dynamic process and changes dramatically in the first months of life. [1] It starts to develop as early as the 10th week of gestation when the foetus starts producing all the necessary coagulation factors by itself
The aim of our study was to estimate the incidence of thrombosis in a population of Slovenian newborns and to study risk factors, location and treatment of thrombotic events
Several coagulation factors are present in very low concentrations and prolonged prothrombin time and activated partial thromboplastin time are usually present in newborns, haemostasis in a normal situation still works as a well balanced mechanism without a higher risk of thrombotic events
Summary
Neonatal haemostasis is a dynamic process and changes dramatically in the first months of life. [1] It starts to develop as early as the 10th week of gestation when the foetus starts producing all the necessary coagulation factors by itself. Several coagulation factors are present in very low concentrations and prolonged prothrombin time and activated partial thromboplastin time are usually present in newborns, haemostasis in a normal situation still works as a well balanced mechanism without a higher risk of thrombotic events. The fibrinolytic process is diminished due to decreased concentration and activity of plasminogen and increased concentration of plasminogen activator inhibitors. The concentration of these factors rises in the weeks of life and reaches adult values at about 6 months of life. [2] The incidence of thrombosis in the paediatric population is highest in newborns, as about 10% of thrombotic events occur in the first four weeks of life.
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