Abstract Number: LPB0027
Meeting: ISTH 2021 Congress
Background: Neonatal portal vein thrombosis (PVT) is increasingly recognized with medical advances in neonatal care. The goal of treatment is avoiding long-term complications such as portal hypertension (PHN). However, the exact incidence and utility of anticoagulation remains unknown.
Aims: To perform a systematic literature review on neonatal PVT to identify the incidence, risk factors, management, and outcomes.
Methods: A search of Pubmed, EMBASE, CINAHL, and Web of science databases was conducted for publications from 1946-2019 and downloaded into Covidence©. Studies with ≥5 neonates (≤28 days of age) were included.
Results: 2956 articles were retrieved; 51 were included in the final analysis after abstract and full-text screening by 2 authors. Pooled PVT incidence was 1.1/100,000 live births (1 study), 16.6/1000 neonatal intensive care unit admissions (2 studies), and 10.6/100 umbilical venous catheter (UVC) insertions (12 studies). In studies with available information, sepsis and thrombophilia occurred in 33.2% and 14.7%, respectively. Other risk factors for PVT included prematurity, congenital anomalies, and blood transfusion through the UVC. Ten studies reported management and outcome for 561 subjects. Anticoagulation therapy was used in 36.9%. Complete or partial resolution was observed in 78.3%, PVT was stable in 20.6%, and thrombus progression occurred in 1.2% after a median follow-up of 6 weeks to 16.6 months. In 2 studies examining the utility of anticoagulation, no improvement in partial or complete thrombus resolution was described (OR 0.77, 95% CI 0.45-1.31). Two studies reported PHN in 0.45% and 3% after follow-up of 5 and 37.2 months, 4 studies reported no PHN after a follow-up of 1.5-16.6 months.
Conclusions: There is a need for larger, well-conducted, multicenter prospective studies in neonates with PVT, to elucidate the risk factors for PHN after long-term follow-up, preferably >5years. Once known, this may improve both management and surveillance strategies for those at risk.
To cite this abstract in AMA style:Alhaddad M, Radadia N, Chan AK, Paes B, Williams S, D Bhatt M. Systematic Review on Neonatal Portal Vein Thrombosis [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/systematic-review-on-neonatal-portal-vein-thrombosis/. Accessed December 11, 2023.
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