Abstract：Objective To study the correlation between coagulation function and gestational age in preterm infants and the possible value of coagulation function measurement in predicting hemorrhagic diseases. Methods The clinical data of preterm infants who were hospitalized between September 2016 and August 2017 were collected. The coagulation indicators were measured within 2 hours after birth. According to the gestational age, the preterm infants were divided into late preterm infant group (n=322), early preterm infant group (n=241) and extremely/very early preterm infant group (n=128). Coagulation function was compared among the three groups, as well as between the preterm infants with and without hemorrhagic diseases within 3 days after birth. Results There were significant differences in thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen degradation product (FDP) and D-dimer (DD) among the three groups (P < 0.05). APTT, PT, FDP and DD were negatively correlated with gestational age, while TT was positively correlated with gestational age (P < 0.05). The preterm infants with hemorrhagic diseases had a longer APTT and a higher level of DD (P < 0.05). Conclusions Coagulation function gradually becomes mature in preterm infants with the increase in gestational age. Abnormal APTT and DD indicate that preterm infants may have a higher risk of hemorrhagic diseases.
GAO Liang,LIN Xin-Zhu,WU Qian-Qian et al. Coagulation function and hemorrhagic diseases in preterm infants with different gestational ages[J]. CJCP, 2019, 21(2): 120-124.
Favaloro EJ, Lippi G. Translational aspects of developmental hemostasis:infants and children are not miniature adults and even adults may be different[J]. Ann Transl Med, 2017, 5(10):212.
[3]
Christensen RD, Baer VL, Lambert DK, et al. Reference intervals for common coagulation tests of preterm infants (CME)[J]. Transfusion, 2014, 54(3):627-632.
[4]
Monagle P, Ignjatovic V, Savoia H. Hemostasis in neonates and children:pitfalls and dilemmas[J]. Blood Rev, 2010, 24(2):63-68.
[5]
Kenet G, Krümpel A, Nowak-Göttl U. Bleeding issues in neonates, infants and young children[J]. Thromb Res, 2009, 123(Suppl 2):S35-S37.
[6]
Lippi G, Franchini M. Vitamin K in neonates:facts and myths[J]. Blood Transfus, 2011, 9(1):4-9.
[7]
Raith W, Fauler G, Pichler G, et al. Plasma concentrations after intravenous administration of phylloquinone (vitamin K1) in preterm and sick neonates[J]. Thromb Res, 2000, 99(5):467-472.
Attard C, van der Straaten T, Karlaftis V, et al. Developmental hemostasis:age-specific differences in the levels of hemostatic proteins[J]. J Thromb Haemost, 2013, 11(10):1850-1854.
[11]
Guzzetta NA, Miller BE. Principles of hemostasis in children:models and maturation[J]. Paediatr Anaesth, 2011, 21(1):3-9.
[12]
Pichler E, Pichler L. The neonatal coagulation system and the vitamin K deficiency bleeding-a mini review[J]. Wien Med Wochenschr, 2008, 158(13-14):385-395.
[13]
Tripodi A. D-dimer testing in laboratory practice[J]. Clin Chem, 2011, 57(9):1256-1262.
[14]
Tripodi A, Ramenghi LA, Chantarangkul V, et al. Normal thrombin generation in neonates in spite of prolonged conventional coagulation tests[J]. Haematologica, 2008, 93(8):1256-1259.
Ballabh P. Intraventricular hemorrhage in premature infants:mechanism of disease[J]. Pediatr Res, 2010, 67(1):1-8.
[17]
Peyvandi F, Palla R, Menegatti M, et al. Coagulation factor activity and clinical bleeding severity in rare bleeding disorders:results from the European Network of Rare Bleeding Disorders[J]. J Thromb Haemost, 2012, 10(4):615-621.
[18]
van Ommen CH, Peters M. The bleeding child. Part I:primary hemostatic disorders[J]. Eur J Pediatr, 2012, 171(1):1-10.
