Neonatal Thrombosis: Are We Doing the Right Studies?

Although neonatal thrombosis may be fatal or cause serious morbidity in survivors, strong clinical recommendations on the management of affected infants could not be made in the 1980s because of the lack of sound data from high-quality studies. To determine whether the "right" studies are now being done, a Medline search (exp infant, newborn, and exp thrombosis) for English language articles 1991-1994, was done and 135 citations were found. After exclusion of 59 nonrelevant articles (such as thrombosis in pregnant women or in vitro studies), plus nine letters to the editor, two reviews, and one consensus report, 64 original articles remained. Eighty-four percent of those (54 citations) were case reports and small case series. Experimental designs (prospective or retrospective cohort and case-control studies) were used in only 10 reports. The recently published literature on neonatal thrombosis continues to show an overabundance of anecdotal reports and a shortage of well-designed collaborative studies. The latter are sorely needed to improve the management of affected infants.