Author/Editor     Nosan, Gregor; Grošelj-Grenc, Mojca; Paro Panjan, Darja
Title     Thrombosis in newborns: experience from 31 cases
Type     članek
Source     Signa vitae: specialized medical journal
Vol. and No.     Letnik 7, št. 2
Publication year     2012
Volume     str. 29-32
Language     eng
Abstract     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. Although 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. At birth, a term newborn has a 30 to 50% lower concentration of vitamin K-dependent procoagulant factors II, VI, IX, X, contact factors XI, XII, precalicrein and high-molecular weight kininogen. On the other hand, the concentration of anticoagulant factors, such as protein C,S, antithrombin and heparin cofactor II, is also lower. The fibrinolytic process is also diminished due to decreased concentration and activity of plasminogen and increased concentration of plasminogen activator inhibitors. The concentration of these factors rises in the next weeks of life and reachesadult values at about 6 months of life. Generally, a thrombotic event is the result of congenital or acquired prothrombotic risk factors. (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. (3) Ahealthy term newborn without prothrombotic risk factors does not risk thrombosis more than an older child. However, as prothrombotic risk factors are more often present in this period of life, the likelihood of thrombosis increases almost fivefold in comparison to the general paediatric population. (4) Around 90% of all thrombotic events are due to acquired and the rest to congenital risk factors. (Abs. trunc. at 2000 ch.)