Department of Biophysics and Systems Biology, Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russian Federation.
National Research Center for Obstetrics, Gynecology and Perinatology named after Academician V. I. Kulakov of the Ministry of Healthcare of Russian Federation, Moscow, Russian Federation.
Pediatr Res. 2019 Jan;85(1):63-71. doi: 10.1038/s41390-018-0184-8. Epub 2018 Sep 18.
Preterm newborns are at thrombohemorrhagic risk during the early neonatal period. Taking into account the lack of informative tools for the laboratory diagnosis of hemostasis disorders in newborns, our goal was to determine the baseline values of thrombodynamics and platelet functional activity in healthy term and moderately preterm newborns during the early neonatal period future potential clinical use of these tests.
Coagulation was assessed using an integral assay of thrombodynamics and standard coagulation assays, and platelet functional activity was estimated by flow cytometry.
Hypercoagulation of newborns, represented by a significantly higher clot growth velocity and the presence of spontaneous clots in the thrombodynamics, was combined with platelet hypoactivity. Granule release, phosphatidylserine exposure, and the ability to change shape upon activation were decreased in the platelets of moderately preterm newborns. The platelet function remained at the same level over the first four days of life, whereas the hypercoagulation became less pronounced.
The hemostasis of newborns is characterized by hypercoagulation combined with reduced platelet functional activity. Moderately preterm and term newborns do not differ in the parameters of coagulation, while some of the functional responses of platelets are lower in moderately preterm newborns than in term.
早产儿在新生儿早期存在血栓出血风险。考虑到缺乏用于新生儿止血障碍实验室诊断的信息性工具，我们的目标是确定健康足月和中度早产儿在新生儿早期的血栓动力和血小板功能活性的基线值，以便未来潜在地临床应用这些测试。
使用血栓动力的整体测定和标准凝血测定评估凝血，通过流式细胞术评估血小板功能活性。
新生儿表现出高凝状态，血栓动力显示凝块生长速度明显加快，存在自发性凝块，同时伴有血小板功能低下。中度早产儿的血小板颗粒释放、磷脂酰丝氨酸暴露和激活时的形态改变能力降低。血小板功能在生命的头四天保持不变，而高凝状态变得不那么明显。
新生儿的止血特点是高凝状态合并血小板功能活性降低。中度早产儿和足月新生儿在凝血参数上没有差异，而中度早产儿的血小板一些功能反应低于足月新生儿。
