CHU Lille, Hematology and Transfusion, F-59000, Lille, France.
Univ. Lille, EA 2694 - Epidemiology and quality of care, Lille, France.
Ital J Pediatr. 2019 Aug 28;45(1):113. doi: 10.1186/s13052-019-0709-8.
Defining hemostatic profile for preterm infants is a challenge when severe bleedings are frequent.
The aim was to define the hemostatic profile at birth of infants with spontaneous prematurity and to evaluate whether characteristic profiles can predict the development of intraventricular hemorrhage (IVH) in prematures.
We included 122 newborns with a median age of 31 gestational age (GA) [29;34] and median weight of 1145 g [785;1490]. Levels of fibrinogen, factor II (FII) and factor V (FV) rose with GA (p = 0.017,p = 0.009, p = 0.001). In the group of 23 - 28 GA, the 5th percentile was defined as 0.6 g/L for fibrinogen, 15 IU/dL for FII and 16 IU/dL for factor V (n = 30). In the group of 29-32 GA, the 5th percentile was defined as 1.0 g/L for fibrinogen, 24 IU/dL for FII and 41 IU/dL for factor V (n = 46). In the group of 33-36 GA, the 5th percentile was defined as 1.0 g/L for fibrinogen, 24 IU/dL for FII and 30 IU/dL for factor V (n = 46). Level of fibrinogen was higher in case of vaginal delivery and lower in case of IUGR. Only lower level of FV at birth was significantly associated with IVH (63.5 [46.0; 76.5] vs 74.0 [58.0; 89.0], p = 0.026) with an unadjusted OR per SD increase in FV of 0.57 (95%CI, 0.34 to 0.96). After adjustment for age, the association between FV level and IVH was slightly attenuated (adjusted OR, 0.70; 95%CI, 0.40 to 1.23) but remained not significant (p = 0.22).There was no correlation with FII and fibrinogen.
We can define hemostastic profile of prematures and corroborate references ranges for studied parameters. Further large studies are still called for, to correlate the grade of hemorrhage and the factor V level at birth.
当严重出血频繁发生时，早产儿的止血特征定义是一个挑战。
目的是在自发性早产婴儿出生时定义止血特征，并评估特征性特征是否可以预测早产儿的脑室内出血（IVH）的发生。
我们纳入了 122 名中位胎龄（GA）为 31 周（29；34）和中位体重为 1145g（785；1490）的新生儿。纤维蛋白原、因子 II（FII）和因子 V（FV）的水平随 GA 升高（p=0.017，p=0.009，p=0.001）。在 23-28GA 组中，第 5 百分位数定义为纤维蛋白原 0.6g/L、FII 15IU/dL 和因子 V 16IU/dL（n=30）。在 29-32GA 组中，第 5 百分位数定义为纤维蛋白原 1.0g/L、FII 24IU/dL 和因子 V 41IU/dL（n=46）。在 33-36GA 组中，第 5 百分位数定义为纤维蛋白原 1.0g/L、FII 24IU/dL 和因子 V 30IU/dL（n=46）。阴道分娩时纤维蛋白原水平较高，而宫内生长受限（IUGR）时纤维蛋白原水平较低。只有出生时较低的 FV 水平与 IVH 显著相关（63.5[46.0；76.5] vs 74.0[58.0；89.0]，p=0.026），FV 每增加一个标准差，OR 值为 0.57（95%CI，0.34 至 0.96）。调整年龄后，FV 水平与 IVH 之间的关联略有减弱（调整后的 OR，0.70；95%CI，0.40 至 1.23），但仍无统计学意义（p=0.22）。FV 与 FII 和纤维蛋白原无相关性。
我们可以定义早产儿的止血特征，并证实研究参数的参考范围。仍需要进一步的大型研究来分析出血程度与出生时因子 V 水平的相关性。
