ArticleThrombosis research2025
Optimizing therapeutic enoxaparin in preterm neonates and infants.
Article in Thrombosis research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesThe purpose of this study was to describe the enoxaparin dose required by preterm neonates and infants to achieve therapeutic anti-Xa levels. STUDY
designRetrospective chart review of preterm infants, <12 weeks postnatal age, born before 37 weeks gestation, receiving subcutaneous (SUBQ) enoxaparin every 12 h (q12h) with an anti-Xa goal of 0.5-1 units/mL. The primary endpoint was the enoxaparin dose required to achieve a therapeutic anti-Xa level. Secondary endpoints included initial enoxaparin dose and the frequency of achieving therapeutic anti-Xa levels with the initial dose, index thrombus progression, formation of new thrombi, and suspected or confirmed bleeding.
resultsFifty-six patients were included for analysis. At time of enoxaparin initiation, the median gestational age, post-menstrual age, and weight were 34 weeks and 2 days, 38 weeks and 4 days, and 2.5 kg (kg), respectively. The median dose required to achieve a therapeutic anti-Xa was 2 mg/kg (IQR 1.7-2.6 mg/kg) SUBQ q12h. The median initial enoxaparin dose of 1.7 mg/kg SUBQ q12h aligned with formulary recommendations. Twenty-three patients (41 %) achieved a therapeutic anti-Xa with the initial dose. Follow-up ultrasounds were available for 38 patients, of which 3 (8 %) showed progression of the index thrombus and 5 (13 %) showed formation of a new thrombus. One patient discontinued enoxaparin due to pulmonary hemorrhage, necessitating protamine administration.
conclusionsPreterm neonates appear to require a median enoxaparin dose of 2 mg/kg subcutaneously every 12 h to achieve therapeutic anti-Xa levels.
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