The use of low molecular weight heparin in pediatric patients: a prospective cohort study

J Pediatr. 2000 Apr;136(4):439-45. doi: 10.1016/s0022-3476(00)90005-2.


Objective: Low molecular weight heparins (LMWHs) offer several advantages over standard anticoagulant therapy (unfractionated heparin/warfarin) including predictable pharmacokinetics, minimal monitoring, and subcutaneous administration. Our objective was to determine the safety and efficacy of LMWHs in children.

Methods: A prospective cohort of children treated with the LMWH enoxaparin (Rhone Poulenc Rorer) was monitored at the Hospital for Sick Children, Toronto, Canada, from March 1994 until July 1997.

Results: There were 146 courses of LMWH administered for treatment and 31 courses for prophylaxis of thromboembolic events (TEs). Clinical resolution of TEs occurred in 94% of children receiving therapeutic doses of LMWH, and 96% of children receiving prophylactic doses of LMWH had no symptoms of recurrent or new TEs. Major bleeding occurred in 5% of children receiving therapeutic doses. Recurrent or new TEs occurred in 1% and 3% of children receiving therapeutic and prophylactic doses of LMWH, respectively.

Conclusion: LMWH appears to be efficacious and safe for both management and prophylaxis of TEs. The results of this cohort study justify a randomized controlled trial comparing LMWH with standard therapy for the management of TEs in children.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Child
  • Child, Preschool
  • Cohort Studies
  • Enoxaparin / administration & dosage*
  • Enoxaparin / adverse effects
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prospective Studies
  • Single-Blind Method
  • Thromboembolism / drug therapy
  • Thromboembolism / mortality
  • Thromboembolism / prevention & control
  • Treatment Outcome


  • Anticoagulants
  • Enoxaparin