Abstract
BACKGROUND: To systematically evaluate the clinical efficacy of rivaroxaban in treating neonatal catheter-related thrombosis (CRT) and analyze risk factors affecting treatment outcomes. METHODS: Clinical data of 122 neonatal CRT patients treated with rivaroxaban from March 2022 to October 2024 at Fujian Provincial Maternal and Child Health Hospital were retrospectively analyzed. The primary outcome was the complete thrombus resolution rate. Multivariate logistic regression was used to analyze risk factors affecting treatment efficacy. RESULTS: Among 122 patients, the complete thrombus resolution rate was 71.31% (87/122) after 6 weeks of anticoagulation, which significantly increased to 88.52% (108/122) after extending to 3 months (p < 0.01). Multivariate logistic regression analysis showed that chemotherapy (OR = 5.48, 95% CI [1.04-28.73], P < 0.05) and difficult catheter placement (OR = 12.53, 95% CI [3.13-50.22], P < 0.05) were independent risk factors reducing the likelihood of complete thrombus resolution at 3 months. No anticoagulation-related bleeding or other complications were observed during the study period, though the sample size and follow-up period may limit the detection of rare events. CONCLUSION: Retrospective data suggest that rivaroxaban is safe and effective in treating neonatal catheter-related thrombosis, with a higher complete thrombus resolution rate observed at 3 months compared to 6 weeks of anticoagulation therapy. Chemotherapy and difficult catheter placement were identified as independent risk factors affecting treatment efficacy. These findings, derived from a single-center retrospective study, require validation through multi-center, prospective, randomized controlled trials.