Thrombophilia in neonates
Newborn infants are the most susceptible to developing thrombosis or serious thromboembolic complications. More specifically, critically ill neonates are at the greatest risk of developing thromboembolic disease.1
The neonatal haemostatic system is both quantitatively and qualitatively distinct from that of an older child or adult. The neonate exists in an evolving balance of pro-and anticoagulant factors. However the balance is delicate and can be easily tipped.2
There are a variety of acquired risk factors that change the balance of the haemostatic system towards thrombosis. One of the most common risk factors is the presence of central venous catheter (CVC) infections. In addition to this, other factors such as sepsis, mechanical ventilation, perinatal asphyxia and congenital heart disease can also play a role.2
Congenital thrombophilia has been shown to have a higher probability of being present in neonates who have primarily renal, portal or hepatic venous thrombosis. These infants develop the life-threatening complications of purpura fulminans.1
Critical signs and symptoms of thromboembolism in critically ill neonates
|ARTERIAL||Pale and/or |
Reduced blood pressure
|Blood pressure |
higher in arms
than in legs
Veldman A, et al. Thrombosis in the critically ill neonate: incidence, diagnosis, and management. Vasc Health Risk Manag. 2008;4:1337-48.
Haley KM. Neonatal Venous Thromboembolism. Front Pediatr. 2017;5:136.