Enoxaparin for thrombosis in neonates: Preliminary report

Fiammetta Piersigilli, Cinzia Auriti, Mary Haywood Lombardi, Giusi Prencipe, Francesca Campi, Andrea Dotta


Objectives – To investigate the dose of enoxaparin required in neonates to achieve target therapeutic ranges of anti factor Xa 48 hours after starting therapy, and compare this dose to recommended guideline dosages for neonates.

Methods – We retrospectively reviewed 19 records of newborns who received enoxaparin at different doses for the treatment of thrombosis and evaluated how many among them reached the target anti-factor Xa level after 48 hours.

Results – Only 1/5 neonates (20%) treated with 150 UI/kg twice a day, but 100% (6/6) of those treated with 175 UI/kg twice a day reached therapeutic levels of anti-factor Xa at 48 hours. Of the 8 neonates treated with lower starting doses none reached the therapeutic range after 48 hours and these required the highest number of dose changes.

Conclusions – Our results reinforce the need to increase in neonates the dosage of enoxaparin suggested in published guidelines, in order to shorten the time-delay in achieving a therapeutic level of anti-factor Xa, and also reducing the number of blood tests necessary for dosing anti-factor Xa.


Enoxaparin; Neonatal thrombosis; Factor Xa level; NICU

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DOI: https://doi.org/10.5457/p2005-114.72


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