Thrombosis Unit, National Hemophilia Center, Sheba Medical Center, Tel-Hashomer, Israel.
Thromb Haemost. 2010 Feb;103(2):344-50. doi: 10.1160/TH09-05-0282. Epub 2010 Jan 13.
Evaluation of clot formation in neonates is troublesome. Our aim was to investigate cord blood clot formation of pre-term versus full-term infants and adults, using rotating thromboelastogram (ROTEM), Pentafarm, Munich, Germany). ROTEM was investigated in cord blood of 184 full-term and 47 pre-term infants. Measurements of the clotting time (CT), clot formation time (CFT) and maximal clot firmness (MCF) were obtained in order to asses reference values for this age group, and compare between full-term and pre-term neonates and compared to adult controls. For each infant demographic information and data regarding pregnancy and delivery were gathered. Infants were prospectively followed until discharge. CT and CFT were significantly shorter among pre-term and term infants as compared to adults [median CT: 185, 194, 293 seconds respectively, p pound0.001, CFT: 80, 76, 103 seconds respectively, p pound0.001). MCF was lower in pre-term and term as compared to adults (p pound0.001) with significantly lower values in pre-term as compared to full-term neonates (p=0.004). Clotting time and MCF correlated with gestational age (R=0.132, p=0.045, R= 0.259, p<0.001, respectively). No association was found between any ROTEM values and the occurrence of post-natal complications in infants of our study group. This is the first study assessing clot formation by ROTEM in pre-term infants. Clot formation parameters of term and premature infants correlated with gestational age. The predictive value of clot formation tests in neonates deserves further attention.
评估新生儿的血栓形成较为困难。我们的目的是使用旋转血栓弹性描记术（ROTEM）研究早产儿与足月儿及成人的脐血血栓形成。我们研究了 184 例足月产和 47 例早产儿的脐血。测量凝血时间（CT）、凝血形成时间（CFT）和最大血凝块硬度（MCF），以获得该年龄组的参考值，并比较足月儿和早产儿之间以及与成人对照组之间的差异。对于每个婴儿，收集人口统计学信息和妊娠及分娩数据。前瞻性随访婴儿直至出院。与成人相比，早产儿和足月儿的 CT 和 CFT 明显缩短[中位数 CT：分别为 185、194、293 秒，p<0.001，CFT：分别为 80、76、103 秒，p<0.001]。与成人相比，早产儿和足月儿的 MCF 较低（p<0.001），早产儿的 MCF 明显低于足月儿（p=0.004）。凝血时间和 MCF 与胎龄呈正相关（R=0.132，p=0.045，R=0.259，p<0.001）。在本研究组的婴儿中，未发现任何 ROTEM 值与产后并发症的发生之间存在相关性。这是第一项评估早产儿 ROTEM 血栓形成的研究。足月儿和早产儿的血栓形成参数与胎龄相关。血栓形成试验在新生儿中的预测价值值得进一步关注。
