Background: The role of inherited thrombophilia testing in predicting a recurrence of deep vein thrombosis (DVT) after an incident of the first catheter related thrombosis in neonates remains unclear

Aims: To investigate the association between inherited thrombophilia and DVT recurrence.

Methods: We conducted a retrospective regional study of all consecutive ICD10 codes of venous thromboembolism (VTE) in neonate < 28 days (January 1, 2000, to December 31, 2012) in a regional catchment area of southern Sweden using an electronic diagnosis registry. Eligible subjects were children aged 0- 28 days presenting with asymptomatic catheter related thrombosis diagnosed with imaging, and having underwent complete inherited thrombophilia workup after the first DVT event, excluding central nervous thrombosis. Of the 25 patients diagnosed with DVTs,
17 were eligible for inclusion.

Results: A total of 17 patients had inherited thrombophilia workup after the incident of the first asymptomatic catheter related thrombosis. Inherited thrombophilia was found in 47% of patients, the prevalence of minor thrombophilia among these 17 patients was 41% (n = 7), whereas major thrombophilia accounted for 12% (n = 2) of abnormal results. Anticoagulants as treatment were administered in 60% of the first DVT. The majority of the cohort treated with anticoagulation therapy for 42-90 days. Both patients with major inherited thrombophilia were treated with anticoagulation therapy for 180 days. There was no report for pulmonary embolism, propagation or thrombosis recurrence after their incident of the first DVT in 3 years minimum follow up time in both treated with anticoagulation therapy and observed groups.

Conclusions: Inherited thrombophilia was not predictive of recurrent DVT among our cohort patients. Our findings suggest that Inherited thrombophilia testing may not predict risk for the recurrence neonatal catheter related thrombosis. Anticoagulation therapy should be evaluated on a case-by-case basis after careful assessment of the risk factors for thrombosis and bleeding.

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ISTH Congress Abstracts - https://abstracts.isth.org/abstract/asymptomatic-catheter-related-thrombosis-in-neonates-the-role-of-thrombophilia-testing/