Clinical, Laboratory, and Therapeutic Analyses of 21 Patients with Neonatal Thrombosis and Antiphospholipid Antibodies: A Literature Review

Abstract

Objectives. A review of the literature reports neonatal thrombosis and antiphospholipid antibodies cases through a retrospective study that focuses on the pathogenesis and main clinical and laboratory manifestations of this disease. Methods. The case reports were selected from PubMed. The keywords used to search were neonatal, antiphospholipid syndrome, thrombosis, and antiphospholipid antibodies. References that were published from 1987 to 2013 were reviewed. Results. Twenty-one cases of neonatal thrombosis and antiphospholipid antibodies were identified. Ten children were born preterm (before 37 weeks). Arterial involvement (17/21) was predominant, of which stroke (12/17) was the most prevalent clinical manifestation. Anti-cardiolipin antibodies were predominant (13/21) in the antiphospholipid antibody profiles. Treatments were based on the use of symptomatics such as antiepileptics (8/21), and 6/21 patients received heparin. There were 4 deaths (4/21); otherwise, the children recovered well, especially the neonates who suffered from strokes (9/12). Conclusion. Neonatal thrombosis and antiphospholipid antibodies are rare. The development of thrombotic manifestations in neonates seems not to be associated exclusively with the aPL, but their etiology may be linked to pre- and perinatal events. We noted good therapeutic responses, especially in stroke patients, who presented with favorable outcomes in 82% of the cases.

Portal vein thrombosis, livedo reticularis, polymicrobial sepsis and high antiphospholipid antibody titers in a newborn: A clinicopathological conference of antiphospholipid-associated neonatal syndrome

“…Majority of patients had anticardiolipin antibodies and risk of thrombosis was increased in presence of risk factors like sepsis, dehydration, parenteral nutrition and central catheterization. 4…”

“…A review has described only 21 cases of neonatal thrombosis in association with aPL antibodies. 4 Fifteen mothers had either primary or secondary APS and 6 mothers were healthy. Arterial thrombosis was predominant with stroke being the most prevalent clinical manifestation in the described cases.…”

Prevention of Pregnancy Complications in Antiphospholipid Syndrome

“…Luckily, neonatal thrombosis due to aPL is rare. 91 Because of the incompleteness of the fetal bloodbrain barrier, aPL could theoretically reach the fetal brain. Whether it can have an effect on brain development is still under investigation.…”

“APS pregnancy – The offspring”

“…The review by Peixoto et al. 35 analyzed 21 published cases of neonatal thrombosis in newborns with antiphospholipid antibodies published from 1987 to 2013. Arterial thrombosis prevailed (17/21), and among them, the main observed manifestation were strokes (12/17).…”