Bleeding Scoring Systems in Neonates: A Systematic Review

Rozeta Sokou; Stavroula Parastatidou; Aikaterini Konstantinidi; Andreas G. Tsantes; Nicoletta Iacovidou; Daniele Piovani; Stefanos Bonovas; Argirios E. Tsantes

doi:10.1055/s-0043-1777070

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2024; 50(04): 620-637
DOI: 10.1055/s-0043-1777070

Review Article

Bleeding Scoring Systems in Neonates: A Systematic Review

Rozeta Sokou

¹Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, Piraeus, Greece

,

Stavroula Parastatidou

²Neonatal Intensive Care Unit, “Elena Venizelou” Maternity Hospital, Athens, Greece

,

Aikaterini Konstantinidi

¹Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, Piraeus, Greece

,

Andreas G. Tsantes

³Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

,

Nicoletta Iacovidou

⁴Neonatal Department, Aretaeio Hospital, National and Kapodistrian University of Athens, Athens, Greece

,

Daniele Piovani

⁵Department of Biomedical Sciences, Humanitas University, Milan, Italy

⁶IRCCS Humanitas Research Hospital, Milan, Italy

,

Stefanos Bonovas

⁵Department of Biomedical Sciences, Humanitas University, Milan, Italy

⁶IRCCS Humanitas Research Hospital, Milan, Italy

,

Argirios E. Tsantes

³Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece

› Author Affiliations

Abstract

We conducted a systematic review aiming to summarize the data on the current hemorrhage prediction models and evaluate their potential for generalized application in the neonatal population. The electronic databases PubMed and Scopus were searched, up to September 20, 2023, for studies that focused on development and/or validation of a prediction model for bleeding risk in neonates, and described the process of model building. Nineteen studies fulfilled the inclusion criteria for the present review. Eighteen bleeding risk prediction models in the neonatal population were identified, four of which were internally validated, one temporally and one externally validated. The existing prediction models for neonatal hemorrhage are mostly based on clinical variables and do not take into account the clinical course and hemostatic profile of the neonates. Most studies aimed at predicting the risk of intraventricular hemorrhage (IVH) reflecting the fact that IVH is the most frequent and serious bleeding complication in preterm neonates. A justification for the study sample size for developing the prediction model was given only by one study. Prediction and stratification of risk of hemorrhage in neonates is yet to be optimized. To this end, qualitative standards for model development need to be further improved. The assessment of the risk of bleeding incorporating platelet count, coagulation parameters, and a set of relevant clinical variables is crucial. Large, rigorous, collaborative cohort studies are warranted to develop a robust prediction model to inform the need for transfusion, which is a fundamental step towards personalized transfusion therapy in neonates.

Keywords

neonates - bleeding events - risk of hemorrhage - bleeding risk prediction models - intraventricular hemorrhage

Full Text

References

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