Department of Obstetrics and Gynaecology, Royal Free Hospital, London, UK.
Haemophilia. 2013 Jul;19(4):533-8. doi: 10.1111/hae.12115. Epub 2013 Apr 8.
The coagulation system of the foetus is markedly different from that of adults. To assess the influence of maternal age, mode of delivery and intrapartum events, and foetal gender and weight on the foetal coagulation system. Cord blood was collected from 154 healthy pregnant women, with gestational age 37 - 42 weeks at birth. Mann-Whitney test was used for analysis of binary data and continuous variables were analysed using Pearson's correlation coefficient. Mean cord blood levels of FVIII:C, VWF:Ag, VWF:CB, FIX, FXI, FXII and plasminogen were significantly higher in babies delivered after labour, compared to those delivered after an elective caesarean. Mean cord blood levels of FII (P = 0.003), FV (P = 0.009), FVII (P = 0.0004) and FX (P = 0.0009) were significantly lower in the babies with meconium stained liquor in labour, compared with those with clear liquor. Augmentation with oxytocin, instrumental delivery, did not affect any of the factor levels and duration of labour did not have an effect on the level of coagulation proteins in cord blood. This study provides valuable information about effect of labour on the coagulation system of the foetus. It is concluded that, in cord blood, the results of coagulation parameters in the newborn baby should be considered in light of mode of delivery and events of labour.
胎儿的凝血系统与成人明显不同。为了评估母亲年龄、分娩方式和产时事件以及胎儿性别和体重对胎儿凝血系统的影响。收集了 154 名健康孕妇的脐血,出生时的胎龄为 37-42 周。采用曼-惠特尼检验分析二项数据,采用皮尔逊相关系数分析连续变量。与选择性剖宫产分娩的婴儿相比,产时分娩的婴儿脐血中 FVIII:C、VWF:Ag、VWF:CB、FIX、FXI、FXII 和纤溶酶原的水平明显更高。与清亮羊水分娩的婴儿相比,羊水有胎粪污染的婴儿脐血中 FII(P=0.003)、FV(P=0.009)、FVII(P=0.0004)和 FX(P=0.0009)的水平明显更低。催产素的增强作用、器械分娩均不影响任何因子水平,分娩时间也不影响脐血中凝血蛋白的水平。本研究提供了关于分娩对胎儿凝血系统影响的有价值的信息。结论是,在脐血中,新生儿凝血参数的结果应根据分娩方式和产时事件来考虑。