Coagulation abnormalities in low birth weight infants with peri-intraventricular hemorrhage.

Fifty-four appropriate for gestational age preterm infants (less than 35 weeks gestation) were followed prospectively from birth with coagulation and real-time ultrasound studies. Coagulation analyses included fibrinogen, prothrombin time, thrombin time and platelet count. The occurrence of peri-intraventricular hemorrhage (PIVH) was documented by portable 5 MHz Echo Scanner. Definite PIVH was present in 21 babies (38%). Coagulation studies showed especially lower values of fibrinogen levels in babies of less than 30 weeks gestation compared to a control group without PIVH (p less than 0.03). Furthermore, significant correlation was observed in these patients between platelet count and degree of PIVH. Infants with Grade 3 and 4 PIVH had lower platelet count than infants with less severe bleeding (Grade 1 and 2) (p less than 0.02). These data suggest that hemostatic abnormalities play a major role as co-factor in the incidence and severity of neonatal PIVH in very low birth weight infants of less than 30 weeks gestation.