Abstract Number: PB0786
Meeting: ISTH 2021 Congress
Background: Among children, neonates have the highest incidence of thrombosis. Multiple risk factors for thrombosis have been reported including central vascular catheters (CVCs), sepsis, and prematurity. Non-O blood group is associated with increased risk of thrombosis in adults and pediatric leukemia patients. However, it has not been studied as a potential risk factor in neonates.
Aims: To evaluate blood group as a risk factor for neonatal thrombosis.
Methods: Retrospective chart review of neonatal thrombosis diagnosed in a single neonatal intensive care unit (NICU) between January-2014 and September-2018, using the Canadian Neonatal Network database. Data on demographics, thrombosis details, blood group and hematocrit were extracted. A multiple imputation model was used to input missing data. The association between risk factors and thrombosis is reported as odds ratio (OR) and compared using Fisher’s exact test. Risk factors with a p-value <0.1 were included in a multiple logistic regression model; p <0.05 was considered statistically significant.
Results: Of 4860 NICU admissions, 186 were associated with thrombosis (38/1000) involving 195 sites (Portal vein, 117; Inferior vena cava, 24; Deep venous except IVC 18; Cardiac, 12; Cerebral sinus venous, 8; Renal vein, 1; and Arterial, 15). On univariate analysis, birth weight <2500 grams, prematurity (GA <37 weeks), CVCs, culture positive sepsis, respiratory distress syndrome (RDS), hematocrit and O blood group were statistically significant risk factors for thrombosis (Table 1). On multivariate analysis, CVCs, culture positive sepsis and RDS remained significant with adjusted ORs of 6.38, 5.16, and 2.41, respectively.
|Variable||Univariate analysis||Multivariate analysis|
|Odds Ratios (95% CI)||P value||Adjusted Odds Ratios (95% CI)||P value|
|Maternal Chorioamnionitis||1.25 (0.76-2.08)||0.374||–||–|
|Maternal gestational diabetes||1.12 (0.75-1.66)||0.581||–||–|
|Maternal hypertension||1.29 (0.87-1.92)||0.200||–||–|
|Gender (Male)||0.86 (0.64-1.16)||0.322||–||–|
|Birth Weight <2500g||1.63 (1.21-2.19)||0.001||0.82 (0.50-1.37)||0.458|
|Prematurity||1.57 (1.15-2.14)||0.004||0.83 (0.48-1.40)||0.478|
|Central catheters||7.16 (4.93-10.39)||<0.001||6.38 (4.38-9.31)||<0.001|
|Culture positive sepsis||7.89 (5.58-11.18)||<0.001||5.16 (3.49-7.63)||<0.001|
|Respiratory distress syndrome||3.01 (2.24-4.05)||<0.001||2.41 (1.62-3.59)||<0.001|
|Hematocrit||0.037 (0.01-0.23)||<0.001||0.21 (0.03-1.51)||0.120|
|Non-O blood group||0.74 (0.55-1.00)||0.050||0.75 (0.55-1.02)||0.067|
Conclusions: Unlike adult and pediatric studies, O blood group approached statistical significance as a risk factor for neonatal thrombosis on univariate analysis. In multivariate analysis, however, previously known risk factors of CVCs, sepsis and RDS remained significant. Further study is required to elucidate the role of blood group as a potential risk factor for neonatal thrombosis.
To cite this abstract in AMA style:Bhatia K, Solanki S, KC Chan A, Paes B, D Bhatt M. Analysis of Novel Risk Factors for Arterial or Venous Thrombosis in Neonates [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/analysis-of-novel-risk-factors-for-arterial-or-venous-thrombosis-in-neonates/. Accessed December 7, 2021.
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