HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS REGISTER		Author Keyword(s) Vol Page [Advanced]

This Article Full Text Full Text (PDF) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this link to a friend Similar articles in ADC Online Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Salonvaara, M Articles by Heinonen, K Search for Related Content PubMed PubMed Citation Articles by Salonvaara, M Articles by Heinonen, K

Effects of gestational age and prenatal and perinatal events on the coagulation status in premature infants

¹ Department of Pediatrics, Kuopio University Hospital and Kuopio University, Kuopio, Finland
² Finnish Red Cross Blood Transfusion Service, Helsinki, Finland
³ Department of Clinical Chemistry, Kuopio University Hospital
⁴ Computing Center, University of Kuopio

Correspondence to:
Correspondence to:
Dr Salonvaara, Department of Pediatrics, Kuopio University Hospital, POB 1777, FIN-70211 Kuopio, Finland;
marjut.salonvaara{at}kuh.fi

Objective: To study prospectively the effects of prematurity and perinatal events on the coagulation status of premature infants.

Patients and main outcome measures: Blood samples from premature infants born before 37 gestational weeks were taken for analysis of coagulation factors II, V, VII, and X and platelet count.

Results: A total of 125 premature infants, 71 boys, were studied at the median postnatal age of 40 minutes (range 12–100). The lowest median activities of coagulation factors II, V, VII, and X and the platelet count were observed, as expected, in infants (n = 21) born at 24–27 weeks gestation. Twin B (n = 14) had lower median activities of coagulation factors II, V, VII, and X than twin A. Infants with evidence of mild asphyxia (Apgar score at 5 minutes < 7 or cord pH < 7.26) had significantly (p < 0.05) lower levels of coagulation factors II, V, VII, and X and platelet counts than infants without asphyxia. Infants who were small for gestational age (SGA) had significantly (p < 0.05) lower levels of coagulation factors V and VII and platelet counts than infants of appropriate size for gestational age. Other prenatal and perinatal variables examined (sex, maternal hypertension and/or pre-eclampsia, antenatal steroid use, mode of delivery, Apgar scores) did not show any significant associations with coagulation status, which may be explained by the small number of infants studied.

Conclusions: The data strongly suggest that there are distinct differences in specific coagulation tests in different patient populations, which could assist in the identification of extremely preterm, SGA, or asphyxiated preterm infants who may be susceptible to haemorrhagic problems perinatally.

Keywords: coagulation factors; prematurity; asphyxia; small for gestational age