PT  - JOURNAL ARTICLE
AU  - W Streif
AU  - G Goebel
AU  - A K C Chan
AU  - M P Massicotte
TI  - Use of low molecular mass heparin (enoxaparin) in newborn infants: a prospective cohort study of 62 patients
AID  - 10.1136/fn.88.5.F365
DP  - 2003 Sep 01
TA  - Archives of Disease in Childhood - Fetal and Neonatal Edition
PG  - F365--F370
VI  - 88
IP  - 5
4099  - http://fn.bmj.com/content/88/5/F365.short
4100  - http://fn.bmj.com/content/88/5/F365.full
SO  - Arch Dis Child Fetal Neonatal Ed2003 Sep 01; 88
AB  - Objective: To detail low molecular mass heparin (enoxaparin) use in the first few months of life. Design: Prospective, consecutive cohort of unselected newborn infants. Methods: Newborn infants were divided into groups by gestational age, underlying condition, hepatic and renal function, thrombocytopenia, and prothrombin time (PT/INR). Groups were analysed with respect to many aspects of enoxaparin treatment using multivariate methods. Results: Sixty two newborn infants received enoxaparin representing 5.39 treatment years. Thromboembolic events (TEs) occurred predominantly in the lower and upper venous system in the presence of indwelling catheters (69%). Preterm infants required longer than full term infants to achieve an anti-(factor Xa) level in the target range (six versus two days). Preterm infants required higher doses of enoxaparin than full term infants to maintain anti-(factor Xa) levels in the target range (2.1 v 1.7 mg/kg/12 h). Infants with congenital heart disease (CHD) required less enoxaparin than those without CHD to maintain an anti-(factor Xa) level in the target range (1.7 v 2.1 mg/kg/12 h). Impaired renal and liver function influenced the number of dose changes needed (three versus one a month). Complete or partial resolution of TE was accomplished in 59% of newborn infants. Four infants developed major bleeds (1.2% per patient year). Recurrent TE and clot extension occurred in three infants (0.9% per patient year). Conclusions: Preterm infants are more difficult to treat with enoxaparin than full term infants. Enoxaparin appears to be an alternative to treatment with standard heparin or no treatment.