Effect of perinatal risk factors on coagulation system in premature infants

Abstract

Background: neonates have different blood clotting and fibrinolytic activities from the adults. Compared with full-term infants, premature infants are more prone to bleeding diathesis after birth, such as intracranial hemorrhage and pulmonary hemorrhage. The defective coagulation factors in premature infants contribute to predisposition of bleeding in premature infants. Objective: it wasto assess the hemostatic profile by screening tests in preterm infants with perinatal risk factors. Patients and Methods: the study was conducted on 90 subjects, 30 preterm with risk factors, 20 preterm without risk factors, 30 full term and 10 adults. All of them were subjected to full clinical history, examination and routine investigation including CBC, prothrombin time, activated partial thromboplastin time, thrombin time and fibrinogen concentration. Results: the results of this study revealed a prolongation in the PT, APTT and TT together with a lower fibrinogen concentration in the group of preterm without risk factors in comparison with the group of full term and adult and revealed that there is more prolongation in the PT, APTT and TT together with more decrease in fibrinogen concentration in the group of preterm with risk factors in comparison with the group of preterm without risk factors, full term and adult but there is no significant difference between full term and adult as regard PT, APTT, TT and fibrinogen concentration. Conclusion:  preterm infants without perinatal risk factors show a lower hemostatic profile when compared with healthy full term and adult. Preterm infants with perinatal risk factors show more decrease in hemostatic profile when compared with healthy full term and adult. Perinatal risk factors (preeclampsia, diabetes and urinary tract infection) seem to interfere with coagulation protein synthesis.