akusherstvoObstetrics, Gynecology and ReproductionАкушерство, Гинекология и Репродукция2313-73472500-3194IRBIS LLC10.17749/2313-7347/ob.gyn.rep.2024.530akusherstvo-2104Research ArticleREVIEW ARTICLESНАУЧНЫЕ ОБЗОРЫInnovative approaches to assessing risk factors, diagnostics and treatment of neonatal thrombosisИнновационные подходы к оценке факторов риска, диагностике и лечению неонатальных тромбозовhttps://orcid.org/0000-0001-7415-4633МакацарияА. Д.MakatsariyaA. D.

Макацария Александр Давидович – д.м.н., профессор, академик РАН, зав. кафедрой акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); вице-президент Российского общества акушеров- гинекологов (РОАГ); Заслуженный врач Российской Федерации; Почетный профессор Венского Университета

Scopus Author ID: 57222220144.

Researcher ID: M-5660-2016

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Alexander D. Makatsariya – MD, Dr Sci Med, Professor, Academician of RAS, Head of the Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health, Sechenov University; Vice-President of the Russian Society of Obstetricians and Gynecologists (RSOG); Honorary Doctor of the Russian Federation; Emeritus Professor of the University of Vienna

Scopus Author ID: 57222220144

Researcher ID: M-5660-2016

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0002-4509-9281ВоробьевА. В.VorobevA. V.

Воробьев Александр Викторович – к.м.н., доцент кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

Scopus Author ID: 57191966265.

Researcher ID: F-8804-2017

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Alexander V. Vorobev – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health

Scopus Author ID: 57191966265.

Researcher ID: F-8804-2017

8 bldg. 2, Trubetskaya Str., Moscow 119991

alvorobev@gmail.comhttps://orcid.org/0000-0003-2136-1641ЛазарчукА. В.LazarchukA. V.

Лазарчук Арина Владимировна – студент 6-го курса 

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Arina V. Lazarchuk – 6th year Student

8 bldg. 2, Trubetskaya Str., Moscow 119991

 

https://orcid.org/0009-0009-0732-6808ЭйнуллаеваС. Э.EinullaevaS. E.

Эйнуллаева Сабина Элхан кызы – студент 6-го курса 

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Sabina E. Einullaeva – 6th year Student

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0009-0006-1664-6377ГоменкоН. А.GomenkoN. A.

Гоменко Наталья Александровна – студент 5-го курса 

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Natalia A. Gomenko – 5th year Student

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0009-0003-1701-1750МагомедоваФ. А.MagomedovaF. A.

Магомедова Фатима Абасовна – студент 5-го курса 

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Fatima A. Magomedova – 5th year Student

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0001-8404-1042БицадзеВ. О.BitsadzeV. O.

Бицадзе Виктория Омаровна – д.м.н., профессор РАН, профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Victoria O. Bitsadze – MD, Dr Sci Med, Professor of RAS, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health

Scopus Author ID: 6506003478.

Researcher ID: F-8409- 2017

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0002-0725-9686ХизроеваД. Х.KhizroevaJ. Kh.

Хизроева Джамиля Хизриевна – д.м.н., профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

Scopus Author ID: 57194547147.

Researcher ID: F-8384-2017

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Jamilya Kh. Khizroeva – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health

Scopus Author ID: 57194547147.

Researcher ID: F-8384-2017

8 bldg. 2, Trubetskaya Str., Moscow 119991

 

https://orcid.org/0000-0002-2541-3843МакацарияН. А.MakatsariyaN. A.

Макацария Наталия Александровна – к.м.н., доцент кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

Researcher ID: F-8406-2017

119991 Москва, Трубецкая ул., д. 8, стр. 2

 

Nataliya A. Makatsariya – MD, PhD, Associate Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health

Researcher ID: F-8406-2017

8 bldg. 2, Trubetskaya Str., Moscow 119991

 

https://orcid.org/0000-0003-2044-2490ЗубенкоВ. Б.ZubenkoV. B.

Зубенко Владислав Борисович – соискатель кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский университет); зам. главного врача по акушерско-гинекологической помощи ГБУЗ Ставропольского края «Ставропольский краевой клинический перинатальный центр»

119991 Москва, Трубецкая ул., д. 8, стр. 2;

355002 Ставрополь, ул. Ломоносова, д. 44

Vladislav B. Zubenko – MD, Degree Seeking Applicant, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health, Sechenov University; Deputy Chief Physician for Obstetrics and Gynecology, Stavropol Regional Clinical Perinatal Center

8 bldg. 2, Trubetskaya Str., Moscow 119991,

44 Lomonosov Str., Stavropol 355002

 

https://orcid.org/0000-0002-3628-0804ТретьяковаМ. В.TretyakovaM. V.

Третьякова Мария Владимировна – к.м.н., ассистент кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

119991 Москва, Трубецкая ул., д. 8, стр. 2

Maria V. Tretyakova – MD, PhD, Assistant, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0002-3367-9844БлиновД. В.BlinovD. V.

Блинов Дмитрий Владиславович – к.м.н., ассистент кафедры спортивной медицины и медицинской реабилитации Института клинической медицины имени Н.В. Склифосовского ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); руководитель по медицинским и научным вопросам, Институт Превентивной и Социальной Медицины; доцент кафедры спортивной, физической и реабилитационной медицины АНО ДПО «Московский медико-социальный институт имени Ф.П. Гааза»

119991 Москва, Трубецкая ул., д. 8, стр. 2;

127006 Москва, ул. Садовая-Триумфальная, д. 4–10;

123056 Москва, 2-я Брестская ул., д. 5, с. 1–1а

Dmitry V. Blinov – MD, PhD, MBA, Assistant, Department of Sports Medicine and Medical Rehabilitation, Sklifosovsky Institute of Clinical Medicine, Sechenov University; Head of Medical and Scientific Affairs, Institute for Preventive and Social Medicine; Associate Professor, Department of Sports, Physical and Rehabilitation Medicine, Moscow Haass Medical – Social Institute

Scopus Author ID: 6701744871.

Researcher ID: E-8906-2017.

RSCI: 9779-8290

8 bldg. 2, Trubetskaya Str., Moscow 119991,

4–10 Sadovaya-Triumfalnaya Str., Moscow 127006,

5 bldg. 1–1a, 2-ya Brestskaya Str., Moscow 123056

https://orcid.org/0000-0002-8882-1588ЯгубоваФ. Э.YagubovaF. E.

Ягубова Фидан Эльчин кызы – клинический ординатор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

119991 Москва, Трубецкая ул., д. 8, стр. 2

Fidan E. Yagubova – MD, Clinical Resident, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children's Health

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0003-0764-4477ГашимоваН. Р.GashimovaN. R.

Гашимова Нилуфар Рамиль кызы – аспирант кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

119991 Москва, Трубецкая ул., д. 8, стр. 2

Nilufar R. Gashimova – MD, Postgraduate Student, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0002-7756-8935ГригорьеваК. Н.GrigorevaK. N.

Григорьева Кристина Николаевна – ассистент кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова 

119991 Москва, Трубецкая ул., д. 8, стр. 2

Kristina N. Grigoreva – MD, Assistant, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health

8 bldg. 2, Trubetskaya Str., Moscow 119991

https://orcid.org/0000-0001-9447-110XПониманскаяМ. А.PonimanskayaM. A.

Пониманская Мария Александровна – к.м.н., зам. главного врача по акушерско-гинекологической помощи

123423 Москва, ул. Саляма Адиля, д. 2/44

Maria A. Ponimanskaya – MD, PhD, Deputy Chief Medical Officer for Obstetric and Gynecological Care, Vorokhobov City Clinical Hospital No. 67

2/44 Salyama Adilya Str., Moscow 123423

https://orcid.org/0000-0002-7770-2751ЛиО. Н.LiO. N.

Ли Ок Нам – к.м.н., зам. главного врача

123423 Москва, ул. Саляма Адиля, д. 2/44

Ok Nam Li – MD, PhD, Deputy Chief Medical Officer, Vorokhobov City Clinical Hospital No. 67

2/44 Salyama Adilya Str., Moscow 123423

МостовойА. В.MostovoiA. V.

Мостовой Алексей Валерьевич – к.м.н., руководитель службы реанимации и интенсивной терапии ГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова Департамента здравоохранения города Москвы»; доцент кафедры неонатологии имени профессора В.В. Гаврюшова ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ассистент кафедры поликлинической терапии, клинической лабораторной диагностики и медицинской биохимии ИПДО ФГБОУ ВО «Ярославский государственный медицинский университет» Министерства здравоохранения Российской Федерации; главный внештатный специалист-неонатолог Министерства здравоохранения Российской Федерации в Северо-Кавказском федеральном округе

123423 Москва, ул. Саляма Адиля, д. 2/44;

123995 Москва, ул. Баррикадная, 2/1, корп. 1;

150000 Ярославль, ул. Революционная, д. 5

Aleksei V. Mostovoi – MD, PhD, Head of Resuscitation and Intensive Care Service, Vorokhobov City Clinical Hospital No. 67; Associate Professor, Gavryushov Neonatal Department, Russian Medical Academy of Continuous Professional Education; Assistant, Department of Polyclinic Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University; Chief External Neonatologist of the Ministry of Health of the Russian Federation in the North Caucasus Federal District

2/44 Salyama Adilya Str., Moscow 123423;

2/1 bldg. 1, Barrikadnaya Str., Moscow 123993;

5 Revolutsionnaya Str., Yaroslavl 150000

https://orcid.org/0000-0002-1024-0230КарповаА. Л.KarpovaA. L.

Карпова Анна Львовна – к.м.н., зав. неонатологическим стационаром ГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова Департамента здравоохранения города Москвы»; доцент кафедры неонатологии имени профессора В.В. Гаврюшова ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ассистент кафедры поликлинической терапии, клинической лабораторной диагностики и медицинской биохимии ИПДО ФГБОУ ВО «Ярославский государственный медицинский университет» Министерства здравоохранения Российской Федерации

123423 Москва, ул. Саляма Адиля, д. 2/44;

123995 Москва, ул. Баррикадная, 2/1, корп. 1;

150000 Ярославль, ул. Революционная, д. 5

Anna L. Karpova – MD, PhD, Head of Neonatal Department of Perinatal Center, Vorohobov City Clinical Hospital No. 67; Associate Professor, Gavryushov Neonatal Department, Russian Medical Academy of Continuous Professional Education; Assistant, Department of Polyclinic Therapy, Clinical Laboratory Diagnostics and Medical Biochemistry, Yaroslavl State Medical University

2/44 Salyama Adilya Str., Moscow 123423;

2/1 bldg. 1, Barrikadnaya Str., Moscow 123993;

5 Revolutsionnaya Str., Yaroslavl 150000

https://orcid.org/0000-0002-9899-9910ГриЖ-К.GrisJ-C.

Гри Жан-Кристоф – д.м.н., профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова

Scopus Author ID: 7005114260.

Researcher ID: AAA-2923-2019

119991 Москва, Трубецкая ул., д. 8, стр. 2;

34090 Монпелье, ул. Огюста Бруссоне, д. 163

Jean-Christophe Gris – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor of Haematology, Head of the Laboratory of Haematology, Faculty of Biological and Pharmaceutical Sciences, Montpellier University and University Hospital of Nîmes, France; Foreign Member of RAS

Scopus Author ID: 7005114260.

Researcher ID: AAA-2923-2019

8 bldg. 2, Trubetskaya Str., Moscow 119991,

163 Rue Auguste Broussonnet, Montpellier 34090, France

https://orcid.org/0000-0002-9576-1368ЭлаламиИ.ElalamyI.

Элалами Исмаил – д.м.н., профессор кафедры акушерства, гинекологии и перинатальной медицины Клинического института детского здоровья имени Н.Ф. Филатова ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); профессор медицинского Университета Сорбонны, Париж, Франция; директор гематологии Центра Тромбозов, Госпиталь Тенон

119991 Москва, Трубецкая ул., д. 8, стр. 2;

Франция, 75006 Париж, Улица медицинского факультета, д. 12;

75020 Париж, Китайская улица, д. 4

Ismail Elalamy – MD, Dr Sci Med, Professor, Department of Obstetrics, Gynecology and Perinatal Medicine, Filatov Clinical Institute of Children’s Health, Sechenov University; Professor, Medicine Sorbonne University, Paris, France; Director of Hematology, Department of Thrombosis Center, Hospital Tenon

Scopus Author ID: 7003652413.

Researcher ID: AAC-9695-2019

8 bldg. 2, Trubetskaya Str., Moscow 119991,

12 Rue de l’École de Médecine, Paris 75006, France; 

4 Rue de la Chine, Paris 75020

ФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет)РоссияSechenov UniversityRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); ГБУЗ Ставропольского края «Ставропольский краевой клинический перинатальный центр»РоссияSechenov University; Stavropol Regional Clinical Perinatal CenterRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Институт Превентивной и Социальной Медицины; АНО ДПО «Московский медико-социальный институт имени Ф.П. Гааза»РоссияSechenov University; Institute for Preventive and Social Medicine; Moscow Haass Medical – Social InstituteRussian FederationГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова Департамента здравоохранения города Москвы»РоссияVorokhobov City Clinical Hospital № 67, Moscow Healthcare DepartmentRussian FederationГБУЗ «Городская клиническая больница № 67 имени Л.А. Ворохобова Департамента здравоохранения города Москвы»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Министерства здравоохранения Российской Федерации; ФГБОУ ВО «Ярославский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииРоссияVorokhobov City Clinical Hospital № 67, Moscow Healthcare Department; Russian Medical Academy of Continuous Professional Education, Health Ministry of Russian Federation; Yaroslavl State Medical University, Health Ministry of Russian FederationRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Университет МонпельеРоссияSechenov University; University of MontpellierRussian FederationФГАОУ ВО Первый Московский государственный медицинский университет имени И.М. Сеченова Министерства здравоохранения Российской Федерации (Сеченовский Университет); Медицинский Университет Сорбонны; Госпиталь ТенонРоссияSechenov University; Medicine Sorbonne University; Hospital TenonRussian Federation202405072024183382400Copyright © Makatsariya A.D., Vorobev A.V., Lazarchuk A.V., Einullaeva S.E., Gomenko N.A., Magomedova F.A., Bitsadze V.O., Khizroeva J.K., Makatsariya N.A., Zubenko V.B., Tretyakova M.V., Blinov D.V., Yagubova F.E., Gashimova N.R., Grigoreva K.N., Ponimanskaya M.A., Li O.N., Mostovoi A.V., Karpova A.L., Gris J., Elalamy I., 20242024Макацария А.Д., Воробьев А.В., Лазарчук А.В., Эйнуллаева С.Э., Гоменко Н.А., Магомедова Ф.А., Бицадзе В.О., Хизроева Д.Х., Макацария Н.А., Зубенко В.Б., Третьякова М.В., Блинов Д.В., Ягубова Ф.Э., Гашимова Н.Р., Григорьева К.Н., Пониманская М.А., Ли О.Н., Мостовой А.В., Карпова А.Л., Гри Ж., Элалами И.Makatsariya A.D., Vorobev A.V., Lazarchuk A.V., Einullaeva S.E., Gomenko N.A., Magomedova F.A., Bitsadze V.O., Khizroeva J.K., Makatsariya N.A., Zubenko V.B., Tretyakova M.V., Blinov D.V., Yagubova F.E., Gashimova N.R., Grigoreva K.N., Ponimanskaya M.A., Li O.N., Mostovoi A.V., Karpova A.L., Gris J., Elalamy I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gynecology.su/jour/article/view/2104

Compared to children of other ages, neonates especially seriously ill and premature subjects comprise a high thrombotic risk group. A decline in the incidence of neonatal thrombosis may be accounted for by improved treatment of severe conditions in newborns and increased survival of premature infants. Neonatal and adult hemostasis exhibit distinct physiological features: difference in concentration, synthesis rate of blood coagulation factors, metabolic rate, thrombin and plasmin levels. At the same time, neonatal threshold values for natural blood coagulation inhibitors (protein C, protein S, antithrombin, heparin cofactor II) and vitamin K-dependent coagulation factors (FII, FVII, FIX, FX) are quite low, whereas that of FVIII and von Willebrand factor exceeds those found in adults. Thus, newborns have lower plasma fibrinolytic activity. The main risk factors for developing thrombotic complications are as follows: central venous catheters, altered body fluid volume, liver disease, as well as sepsis and inflammatory processes particularly COVID-19. The significance of congenital and acquired maternal and neonatal thrombophilia may pose an additional risk factor for thrombotic complications. Low-molecular weight heparins are the first-choice drugs in treatment and prevention of neonatal thrombosis.

Новорожденные относятся к группе высокого тромботического риска по сравнению с детьми других возрастов, в особенности этой патологии подвержены тяжелобольные и недоношенные дети. Снижение частоты случаев неонатальных тромбозов может быть обусловлено улучшением методов лечения тяжелых состояний у новорожденных и повышенной выживаемостью недоношенных детей. Система гемостаза у новорожденных и взрослых имеет известные физиологические различия: у них различаются параметры концентрации, скорости синтеза факторов свертывания крови, скорости обмена веществ, уровни тромбина и плазмина. При этом у новорожденных пороговые показатели естественных ингибиторов свертывания крови (протеинов С и S, антитромбина, кофактора II гепарина) и витамин К-зависимых факторов (F) свертывания (FII, FVII, FIX, FX) достаточно низкие, в то время как содержание FVIII и фактора фон Виллебранда превышает аналогичное у взрослых. Таким образом, у новорожденных наблюдается пониженная фибринолитическая активность плазмы. Основными факторами риска развития тромботических осложнений являются центральные венозные катетеры, изменения объема жидкости в организме, заболевания печени, а также сепсис и воспалительные процессы, в частности COVID-19. Значение врожденной и приобретенной тромбофилии у матери и новорожденного может быть дополнительным фактором риска тромботических осложнений. В терапии и профилактике тромбозов новорожденных препаратами первого выбора являются низкомолекулярные гепарины.

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The authors declare that there are no conflicts of interest present.