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Pathogenesis, clinical features, and diagnosis of thrombosis in the newborn

Authors
Anthony KC Chan, MBBS, FRCPC, FRCPath
Mihir D Bhatt, MD
Section Editors
Donald H Mahoney, Jr, MD
Joseph A Garcia-Prats, MD
Deputy Editor
Carrie Armsby, MD, MPH

INTRODUCTION

Thrombotic disease is uncommon in newborns. However, this disorder can cause serious morbidity. The pathogenesis, clinical features, and diagnosis of neonatal thrombosis, excluding the central nervous system (CNS), are reviewed here. CNS thromboembolic disease and the management of neonatal thrombosis are discussed separately. (See "Stroke in the newborn" and "Management of thrombosis in the newborn".)

COAGULATION IN NEWBORNS

Plasma concentrations of the components of the coagulation cascade (figure 1) and fibrinolytic pathway (figure 2) in newborns differ markedly from older children and adults. Concentrations of these factors change from birth through infancy (table 1) [1-4]. (See "Overview of hemostasis".)

In newborns, the following procoagulant, anticoagulant, and fibrinolytic factors differ considerably compared with adult levels:

Vitamin K-dependent coagulation factors (II, VII, IX, X) and contact factors (XI, XII, prekallikrein, high molecular weight kininogen) are 50 to 70 percent of adult levels [5]. These factors increase rapidly after birth, reaching adult levels of most components by six months of age [1].

Factors V, VIII, XIII, von Willebrand factor, and fibrinogen are at least 70 percent of adult levels [1].

                    

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Literature review current through: Nov 2016. | This topic last updated: Fri Oct 14 00:00:00 GMT+00:00 2016.
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