Innovative approaches to assessing risk factors, diagnostics and treatment of neonatal thrombosis
A. D. Makatsariya,
A. V. Vorobev,
A. V. Lazarchuk,
S. E. Einullaeva,
N. A. Gomenko,
F. A. Magomedova,
V. O. Bitsadze,
J. Kh. Khizroeva,
N. A. Makatsariya,
V. B. Zubenko,
M. V. Tretyakova,
D. V. Blinov,
F. E. Yagubova,
N. R. Gashimova,
K. N. Grigoreva,
M. A. Ponimanskaya,
O. N. Li,
A. V. Mostovoi,
A. L. Karpova,
J-C. Gris,
I. Elalamy https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.530
Abstract
Compared to children of other ages, neonates especially seriously ill and premature subjects comprise a high thrombotic risk group. A decline in the incidence of neonatal thrombosis may be accounted for by improved treatment of severe conditions in newborns and increased survival of premature infants. Neonatal and adult hemostasis exhibit distinct physiological features: difference in concentration, synthesis rate of blood coagulation factors, metabolic rate, thrombin and plasmin levels. At the same time, neonatal threshold values for natural blood coagulation inhibitors (protein C, protein S, antithrombin, heparin cofactor II) and vitamin K-dependent coagulation factors (FII, FVII, FIX, FX) are quite low, whereas that of FVIII and von Willebrand factor exceeds those found in adults. Thus, newborns have lower plasma fibrinolytic activity. The main risk factors for developing thrombotic complications are as follows: central venous catheters, altered body fluid volume, liver disease, as well as sepsis and inflammatory processes particularly COVID-19. The significance of congenital and acquired maternal and neonatal thrombophilia may pose an additional risk factor for thrombotic complications. Low-molecular weight heparins are the first-choice drugs in treatment and prevention of neonatal thrombosis.
About the Authors
A. D. Makatsariya
Sechenov University
Russian Federation
Russian Federation
Alexander D. Makatsariya – MD, Dr Sci Med, Professor, Academician of RAS, Head of the Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health, Sechenov University; Vice-President of the Russian Society of Obstetricians and Gynecologists (RSOG); Honorary Doctor of the Russian Federation; Emeritus Professor of the University of Vienna
Scopus Author ID: 57222220144
Researcher ID: M-5660-2016
8 bldg. 2, Trubetskaya Str., Moscow 119991
A. V. Vorobev
Sechenov University
Russian Federation
Russian Federation
Alexander V. Vorobev – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health
Scopus Author ID: 57191966265.
Researcher ID: F-8804-2017
8 bldg. 2, Trubetskaya Str., Moscow 119991
A. V. Lazarchuk
Sechenov University
Russian Federation
Russian Federation
Arina V. Lazarchuk – 6th year Student
8 bldg. 2, Trubetskaya Str., Moscow 119991
S. E. Einullaeva
Sechenov University
Russian Federation
Russian Federation
Sabina E. Einullaeva – 6th year Student
8 bldg. 2, Trubetskaya Str., Moscow 119991
N. A. Gomenko
Sechenov University
Russian Federation
Russian Federation
Natalia A. Gomenko – 5th year Student
8 bldg. 2, Trubetskaya Str., Moscow 119991
F. A. Magomedova
Sechenov University
Russian Federation
Russian Federation
Fatima A. Magomedova – 5th year Student
8 bldg. 2, Trubetskaya Str., Moscow 119991
V. O. Bitsadze
Sechenov University
Russian Federation
Russian Federation
Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health
Scopus Author ID: 6506003478.
Researcher ID: F-8409- 2017
8 bldg. 2, Trubetskaya Str., Moscow 119991
J. Kh. Khizroeva
Sechenov University
Russian Federation
Russian Federation
Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health
Scopus Author ID: 57194547147.
Researcher ID: F-8384-2017
8 bldg. 2, Trubetskaya Str., Moscow 119991
N. A. Makatsariya
Sechenov University
Russian Federation
Russian Federation
Nataliya A. Makatsariya – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health
Researcher ID: F-8406-2017
8 bldg. 2, Trubetskaya Str., Moscow 119991
V. B. Zubenko
Sechenov University;
Stavropol Regional Clinical Perinatal Center
Russian Federation
Russian Federation
Vladislav B. Zubenko – MD, Degree Seeking Applicant, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health, Sechenov University; Deputy Chief Physician for Obstetrics and Gynecology, Stavropol Regional Clinical Perinatal Center
8 bldg. 2, Trubetskaya Str., Moscow 119991,
44 Lomonosov Str., Stavropol 355002
M. V. Tretyakova
Sechenov University
Russian Federation
Russian Federation
Maria V. Tretyakova – MD, PhD, Assistant, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health
8 bldg. 2, Trubetskaya Str., Moscow 119991
D. V. Blinov
Sechenov University;
Institute for Preventive and Social Medicine;
Moscow Haass Medical – Social Institute
Russian Federation
Russian Federation
Dmitry V. Blinov – MD, PhD, MBA, Assistant, Department of Sports Medicine and Medical Rehabilitation, Sklifosovsky Institute of Clinical Medicine, Sechenov University; Head of Medical and Scientific Affairs, Institute for Preventive and Social Medicine; Associate Professor, Department of Sports, Physical and Rehabilitation Medicine, Moscow Haass Medical – Social Institute
Scopus Author ID: 6701744871.
Researcher ID: E-8906-2017.
RSCI: 9779-8290
8 bldg. 2, Trubetskaya Str., Moscow 119991,
4–10 Sadovaya-Triumfalnaya Str., Moscow 127006,
5 bldg. 1–1a, 2-ya Brestskaya Str., Moscow 123056
F. E. Yagubova
Sechenov University
Russian Federation
Russian Federation
Fidan E. Yagubova – MD, Clinical Resident, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health
8 bldg. 2, Trubetskaya Str., Moscow 119991
N. R. Gashimova
Sechenov University
Russian Federation
Russian Federation
Nilufar R. Gashimova – MD, Postgraduate Student, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health
8 bldg. 2, Trubetskaya Str., Moscow 119991
K. N. Grigoreva
Sechenov University
Russian Federation
Russian Federation
Kristina N. Grigoreva – MD, Assistant, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health
8 bldg. 2, Trubetskaya Str., Moscow 119991
M. A. Ponimanskaya
Vorokhobov City Clinical Hospital № 67, Moscow Healthcare Department
Russian Federation
Russian Federation
Maria A. Ponimanskaya – MD, PhD, Deputy Chief Medical Officer for Obstetric and Gynecological Care, Vorokhobov City Clinical Hospital No. 67
2/44 Salyama Adilya Str., Moscow 123423
O. N. Li
Vorokhobov City Clinical Hospital № 67, Moscow Healthcare Department
Russian Federation
Russian Federation
Ok Nam Li – MD, PhD, Deputy Chief Medical Officer, Vorokhobov City Clinical Hospital No. 67
2/44 Salyama Adilya Str., Moscow 123423
A. V. Mostovoi
Vorokhobov City Clinical Hospital № 67, Moscow Healthcare Department;
Russian Medical Academy of Continuous Professional Education, Health Ministry of Russian Federation;
Yaroslavl State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Aleksei V. Mostovoi – MD, PhD, Head of Resuscitation and Intensive Care Service, Vorokhobov City Clinical Hospital No. 67; Associate Professor, Gavryushov Neonatal Department, Russian Medical Academy of Continuous Professional Education; Assistant, Department of Polyclinic Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University; Chief External Neonatologist of the Ministry of Health of the Russian Federation in the North Caucasus Federal District
2/44 Salyama Adilya Str., Moscow 123423;
2/1 bldg. 1, Barrikadnaya Str., Moscow 123993;
5 Revolutsionnaya Str., Yaroslavl 150000
A. L. Karpova
Vorokhobov City Clinical Hospital № 67, Moscow Healthcare Department;
Russian Medical Academy of Continuous Professional Education, Health Ministry of Russian Federation;
Yaroslavl State Medical University, Health Ministry of Russian Federation
Russian Federation
Russian Federation
Anna L. Karpova – MD, PhD, Head of Neonatal Department of Perinatal Center, Vorohobov City Clinical Hospital No. 67; Associate Professor, Gavryushov Neonatal Department, Russian Medical Academy of Continuous Professional Education; Assistant, Department of Polyclinic Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University
2/44 Salyama Adilya Str., Moscow 123423;
2/1 bldg. 1, Barrikadnaya Str., Moscow 123993;
5 Revolutsionnaya Str., Yaroslavl 150000
J-C. Gris
Sechenov University;
University of Montpellier
Russian Federation
Russian Federation
Jean-Christophe Gris – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor of Haematology, Head of the Laboratory of Haematology, Faculty of Biological and Pharmaceutical Sciences, Montpellier University and University Hospital of Nîmes, France; Foreign Member of RAS
Scopus Author ID: 7005114260.
Researcher ID: AAA-2923-2019
8 bldg. 2, Trubetskaya Str., Moscow 119991,
163 Rue Auguste Broussonnet, Montpellier 34090, France
I. Elalamy
Sechenov University;
Medicine Sorbonne University;
Hospital Tenon
Russian Federation
Russian Federation
Ismail Elalamy – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Medicine Sorbonne University, Paris, France; Director of Hematology, Department of Thrombosis Center, Hospital Tenon
Scopus Author ID: 7003652413.
Researcher ID: AAC-9695-2019
8 bldg. 2, Trubetskaya Str., Moscow 119991,
12 Rue de l’École de Médecine, Paris 75006, France;
4 Rue de la Chine, Paris 75020
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What is already known about this subject?
► Neonatal thrombosis is a quire rare but serious condition that can be fatal for newborns.
► One of the main risk factors for development of neonatal thrombosis is application of central venous catheters.
► Treatment of neonatal thrombosis is a complex process that requires a personalized approach based on thrombus location, patient health condition and other additional risk factors.
What are the new findings?
► New data on risk factors for neonatal thrombosis are presented, taking into account up-to-date research data.
► The influence of congenital and acquired thrombophilia, thromboinflammation and maternal COVID-19 infection on developing neonatal thrombosis was analyzed.
► New methods for prevention and treatment of neonatal thrombosis are discussed able to assist in lowering neonatal mortality and morbidity.
How might it impact on clinical practice in the foreseeable future?
► Implementation of new risk assessment methods for more accurate prediction of developing neonatal thrombosis may prevent it and improve patient outcome.
► Innovative diagnostic approaches described in the article can provide faster and more accurate detection of thrombosis or prethrombotic state, which will allow to apply a proactive treatment and increase therapeutic effectiveness.
► New treatment strategies may lead to revision of approved recommendations for management of patients with neonatal thrombosis.
Review
For citations:
Makatsariya A.D., Vorobev A.V., Lazarchuk A.V., Einullaeva S.E., Gomenko N.A., Magomedova F.A., Bitsadze V.O., Khizroeva J.Kh., Makatsariya N.A., Zubenko V.B., Tretyakova M.V., Blinov D.V., Yagubova F.E., Gashimova N.R., Grigoreva K.N., Ponimanskaya M.A., Li O.N., Mostovoi A.V., Karpova A.L., Gris J., Elalamy I. Innovative approaches to assessing risk factors, diagnostics and treatment of neonatal thrombosis. Obstetrics, Gynecology and Reproduction. 2024;18(3):382-400. (In Russ.) https://doi.org/10.17749/2313-7347/ob.gyn.rep.2024.530
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