Department of Pediatrics, Fukushima Medical University School of Medicine, Fukushima, 960-1295, Japan.
Department of Blood Transfusion and Transplantation Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan.
Int J Hematol. 2023 Feb;117(2):278-282. doi: 10.1007/s12185-022-03476-9. Epub 2022 Nov 11.
Although disseminated intravascular coagulation (DIC) is a critical disease, its mortality in neonates is hard to predict. The aim of this study was to investigate underlying conditions associated with neonatal DIC to see if a scoring system could predict mortality.
We retrospectively evaluated the DIC scores of neonates diagnosed on or after the second day of life, in conjunction with underlying conditions associated with DIC. The diagnosis of DIC was made according to Japan Society of Obstetrical, Gynecological & Neonatal Hematology (JSOGNH) 2016 neonatal DIC criteria.
Among 23 neonates with DIC, 8 had gastrointestinal perforation with necrotizing enterocolitis and 6 had congenital heart disease. Although factors such as birth weight, gestational age, D-dimer, and fibrinogen were not predictive of mortality, median PT-INR differed significantly between the two groups (survived 1.69 vs died 2.37, P = 0.004). Furthermore, median DIC scores differed significantly by survival outcome (P = 0.013).
DIC scores based on JSOGNH 2016 neonatal DIC criteria are predictive of mortality in infants diagnosed with DIC on or after the second day of life.
弥散性血管内凝血（DIC）虽是一种严重疾病，但新生儿 DIC 的死亡率难以预测。本研究旨在探讨与新生儿 DIC 相关的基础疾病，观察是否能建立评分系统预测死亡率。
我们回顾性评估了在出生后第 2 天或之后被诊断为 DIC 的新生儿的 DIC 评分，以及与 DIC 相关的基础疾病。DIC 的诊断依据日本妇产科新生儿血液学会（JSOGNH）2016 年新生儿 DIC 标准。
在 23 例 DIC 新生儿中，8 例存在伴有坏死性小肠结肠炎的胃肠道穿孔，6 例存在先天性心脏病。尽管出生体重、胎龄、D-二聚体和纤维蛋白原等因素与死亡率无关，但两组间的中位 PT-INR 差异有统计学意义（存活组 1.69，死亡组 2.37，P=0.004）。此外，DIC 评分的中位数在生存结果上差异有统计学意义（P=0.013）。
基于 JSOGNH 2016 年新生儿 DIC 标准的 DIC 评分可预测在出生后第 2 天或之后被诊断为 DIC 的婴儿的死亡率。
