{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:23:37Z","timestamp":1779927817128,"version":"3.53.1"},"reference-count":18,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Dosing guidance for anticoagulation, the mainstay of venous thromboembolism (VTE) treatment, is lacking for obese children. We aimed to compare unfractionated heparin (UFH) and low-molecular-weight heparins (LMWH) dosing requirements and clinical outcomes between obese\/overweight and nonobese children.<\/jats:p>\n                  <jats:p>This monocentric retrospective cohort study included patients aged\u2009&lt;\u200918 years old receiving anticoagulation for VTE. The outcomes were: (1) number of dose adjustments to reach therapeutic levels, (2) variation from initial dose, (3) thrombotic progression\/recurrence, and (4) clinically relevant bleeding. Characteristics and dosing requirements of obese\/overweight and nonobese children were compared using Pearson chi-square, Fisher exact, and Wilcoxon Mann\u2013Whitney tests. Kaplan\u2013Meier estimator compared the cumulative incidence of thrombotic recurrence\/progression and clinically relevant bleeding between groups.<\/jats:p>\n                  <jats:p>We included 212 patients (median age: 6.2 years, 23.6% obese\/overweight) having 258 anticoagulation encounters (LMWH: 82.6%, UFH: 17.4%). Most children had therapeutic levels following one dosage (66.7% in obese\/overweight vs. 51.8% in nonobese, p\u2009=\u20090.201). Dosing requirements significantly differed between obese\/overweight and nonobese children (average increase from initial dose: 3.2 vs. 11.3%, p\u2009&lt;\u20090.001). In obese\/overweight children, 11.1% of patients required \u2265 10% dose reduction versus 2.1% in nonobese children (p\u2009&lt;\u20090.001). The cumulative incidence of thrombotic progression\/recurrence was comparable between groups (obese\/overweight: 12.0%, nonobese: 10.5%, p\u2009=\u20090.786). Similarly, clinically significant bleeding was rare for both groups (obese\/overweight: 2.0%, nonobese: 3.1%, p\u2009=\u20090.609).<\/jats:p>\n                  <jats:p>In children treated for VTE, obesity\/overweight was associated with lower anticoagulation requirements. Further prospective work is urgently needed to explore alternate regimens, such as dose capping, reduced initial dosing, or the use of fat-free mass.<\/jats:p>","DOI":"10.1055\/a-2544-6183","type":"journal-article","created":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T20:11:16Z","timestamp":1742847076000},"page":"078-086","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Obesity and Overweight on Heparin Dosing and Clinical Outcomes in Pediatric Patients with Venous Thromboembolism"],"prefix":"10.1055","volume":"126","author":[{"given":"Alexandra","family":"Larouche","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHU de Qu\u00e9bec, Qu\u00e9bec, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Val\u00e9rie","family":"Dollo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHU de Qu\u00e9bec, Qu\u00e9bec, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Mercier","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, CHU de Qu\u00e9bec, Qu\u00e9bec, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narcisse","family":"Singbo","sequence":"additional","affiliation":[{"name":"Recherche Clinique et \u00c9valuative, Centre de Recherche du CHU de Qu\u00e9bec, Qu\u00e9bec, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chantal","family":"\u00c9thier","sequence":"additional","affiliation":[{"name":"Axe Reproduction, Sant\u00e9 de la M\u00e8re et de l'Enfant, Centre de Recherche du CHU de Qu\u00e9bec, Qu\u00e9bec, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Christine","family":"Boulanger","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, CHU de Qu\u00e9bec, Qu\u00e9bec, QC, 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