Bemiparin in neonatal thrombosis: therapeutic dosing and safety

Maria Sanchez-Holgado; Mercedes Sampedro; Carlos Zozaya; Celia Permuy Romero; Patricia Alvarez-Garcia; Leticia La Banda-Montalvo; Clara Nieto; Adelina Pellicer

doi:10.1038/s41372-024-02200-1

Bemiparin in neonatal thrombosis: therapeutic dosing and safety

J Perinatol. 2024 Dec 16. doi: 10.1038/s41372-024-02200-1. Online ahead of print.

Authors

Maria Sanchez-Holgado^#¹, Mercedes Sampedro^#², Carlos Zozaya², Celia Permuy Romero², Patricia Alvarez-Garcia², Leticia La Banda-Montalvo², Clara Nieto², Adelina Pellicer²

Affiliations

¹ Department of Neonatology. La Paz University Hospital, Madrid, Spain. [email protected].
² Department of Neonatology. La Paz University Hospital, Madrid, Spain.

^# Contributed equally.

PMID: 39681735
DOI: 10.1038/s41372-024-02200-1

Abstract

Objective: To evaluate the therapeutic dose and safety of bemiparin in neonatal thrombosis treatment.

Study design: A retrospective review was conducted on infants treated with bemiparin between 2018 and 2023 at a tertiary hospital.

Results: 72 neonates with a mean gestational age of 37 weeks were included. Twenty were preterm, with a median gestational age of 33.5 weeks and a median birth weight of 1847.5 grams. The mean (SD) initial and therapeutic bemiparin doses were 170.5 (31) and 200 (37.2) IU/kg/day, respectively. Only 32% of patients reached the therapeutic target range (TTR) with the initial dose. Preterm infants required higher doses to reach TTR (215 vs 194.7 IU/kg/day, p = 0.05). Adverse events were minimal (1.4%) and unrelated to the starting dose or prematurity.

Conclusion: Bemiparin appears to be a potential therapeutic option for anticoagulation in neonates; however, targeted anti-Xa levels were rarely achieved with the initial dose and most patients required uptitration.