Neonatology pp 1455-1469 | Cite as

The Thrombotic Risk of the Newborn

  • Molinari Angelo ClaudioEmail author
  • Paola Saracco
Reference work entry


The first weeks of life have the highest rate of thrombotic complications in the pediatric age, and thromboembolism mainly affects sick newborns. It is well known that despite low levels of procoagulant factors in the first months of life, newborns show a perfect hemostasis; this is probably due to the balancing effect of the low levels of physiological inhibitors (protein C, protein S, and antithrombin).

Some other pathophysiological insights are available to favor the knowledge of the process that pathological situations may lead newborns to experience thromboembolic complications. In the recent years, genetic prothrombotic conditions have been widely studied but their role in determining thrombosis in the neonates is still under debate. Moreover, in the sick newborn, especially preterm, several acquired perinatal and iatrogenic conditions might result in a disturbance between coagulation and fibrinolysis, leading to thrombus formation. The use of central lines, cardiac diseases and polycythemia, renal diseases such as congenital nephrotic syndrome and neonatal hemolytic uremic syndrome, peripartum asphyxia, infants of diabetic mothers, dehydration, septicemia, necrotizing enterocolitis, acute respiratory distress syndrome, and extracorporeal membrane oxygenation lead to elevated thrombin generation and subsequent thrombus formation.



Anticardiolipin antibodies


Arterial ischemic stroke


Antiphospholipid antibodies


Antiphospholipid syndrome


Arterial thrombosis


Antithrombin (natural anticoagulant)


Central nervous system


Cerebral sinovenous thrombosis


Central venous line


Endogenous thrombin potential




Coagulation factor II


Coagulation factor V


Coagulation factor VII


Coagulation factor VIII


Factor V Leiden (prothrombotic polymorphism of FV)


Coagulation factor X


Coagulation factor XIII


Lupus anticoagulant


Methylenetetrahydrofolate reductase


Plasmin-alpha2-antiplasmin complex


Protein C (natural anticoagulant)


Pulmonary embolism



PRT G20210A

Prothrombotic mutation of factor II G20210A


Protein S (natural anticoagulant cofactor of PC)


Portal vein thrombosis


Renal vein thrombosis


Thrombin–antithrombin complex


Thromboembolic events


Tissue factor


TF pathway inhibitor




Umbilical artery catheter


Umbilical vein catheter


Von Willebrand factor


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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Thrombosis and Hemostasis UnitGiannina Gaslini Children’s HospitalGenovaItaly
  2. 2.Pediatric Hematology, Department of PediatricsUniversity Hospital Città della Salute e della ScienzaTorinoItaly

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