Bemiparin in neonatal thrombosis: therapeutic dosing and safety

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

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

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.

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.