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. 2021 Apr 2;10(7):1483.
doi: 10.3390/jcm10071483.

Effectiveness and Safety of Nadroparin Therapy in Preterm and Term Neonates with Venous Thromboembolism

Jeanine Sol  1   2 , Marit Boerma  3 , Irene Klaassen  4 , Sinno Simons  2 , Bregje Witjes  5 , Enno Wildschut  6 , Irwin Reiss  2 , Cornelia Heleen van Ommen  3
Affiliations

Effectiveness and Safety of Nadroparin Therapy in Preterm and Term Neonates with Venous Thromboembolism

Jeanine Sol et al. J Clin Med. .

Abstract

Introduction: Optimal neonatal nadroparin dosages to treat venous thromboembolism (VTE) are unknown.

Objective: To evaluate therapeutic nadroparin dosages to reach therapeutic target ranges (TTR: 0.5-1.0 International Unit (IU)/mL) and the effectiveness and safety of nadroparin in neonatal VTE.

Methods: Retrospective study including neonates with VTE on nadroparin in a tertiary center between 2007 and 2018. Two groups were distinguished: neonates before (group 1) and after (group 2) switch to higher starting dosages in 2014.

Results: Sixty-one neonates (44 preterm, 17 term) with 64 VTEs were included. TTR was reached in 32/64 (50%) VTEs (group 1: 35.7%; group 2: 61.1%). Median nadroparin dosage to reach TTR was 197 (97.9-330.3) IU/kg/12 h. No therapy-related deaths occurred. Recurrent VTE developed in 6 (9.8%) neonates. Complete clot resolution was observed in 31/41 (75.6%) VTEs. TTR was reached in 58.1% VTEs with complete clot resolution. No major bleeding occurred. Non-major clinically relevant bleedings occurred in 3/64 (4.7%) VTEs, consisting of large hematomas due to the use of subcutaneous catheters.

Conclusions: High nadroparin dosages are needed to reach TTR in neonates, which seem to be safe. Clot resolution may occur without reaching TTR. Subcutaneous catheters may cause important bleeding complications.

Keywords: effectiveness and safety; nadroparin; neonate; therapeutic target range; thrombosis.

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Conflict of interest statement

The authors have no conflict of interest to declare.

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