Istanbul University, Istanbul Medical Faculty, Department of Pediatrics, Division of Neonatology, Istanbul, Turkey.
Blood Coagul Fibrinolysis. 2023 Dec 1;34(8):494-498. doi: 10.1097/MBC.0000000000001256. Epub 2023 Sep 28.
The aim of this study was to define normal percentile values of coagulation parameters in preterm infants below 32 weeks of gestational age. This retrospective cohort study was conducted at Istanbul Medical Faculty. Preterm infants who were born prior to 32 weeks of gestation, between 2011 and 2021 were included and evaluated for coagulation parameters. Blood samples obtained through umbilical catheters prior to administration of heparinized flushes/fluids, vitamin K or fresh frozen plasma (FFP). Infants with a major bleeding disorder, intrapartum asphyxia or a history of familial bleeding disorders were excluded. Infants were grouped according to their gestational ages and birth weights: less than 24, 25-26, 27-28, 29-30, 31-32 weeks and <500, 500-749, 750-999, 1000-1249, 1250-1499, more than 1500 g. Third to 97th percentile values of both prothrombin time (PT) and activated partial thromboplastin time (aPTT) were defined. A total of 420 preterm infants were included. The median value and range of gestational age and birth weight of the infants were 29 (22.3-32.9) weeks and 1150 (395-2790) g, respectively. PT values were similar between subgroups according to gestational age but longer in infants with a birth weight less than 1000 g. aPTT values in infants born less than 24 weeks of gestation were found significantly longer. As maturation of the coagulation system increases by gestational age, very preterm infants (<32 gestational week (GW)) are under increased risk of bleeding. Determination of normal percentile distribution of coagulation parameters for preterm infants will shed light on the interpretation of coagulation parameters of these infants and minimize unnecessary FFP administrations.
本研究旨在确定胎龄低于 32 周的早产儿的凝血参数正常百分位数。这项回顾性队列研究在伊斯坦布尔医科大学进行。纳入了 2011 年至 2021 年胎龄小于 32 周的早产儿，并评估了他们的凝血参数。在给予肝素冲洗/液体、维生素 K 或新鲜冷冻血浆（FFP）之前，通过脐导管采集血液样本。排除有严重出血性疾病、产时窒息或家族性出血性疾病病史的婴儿。根据胎龄和出生体重将婴儿分为以下几组：<24 周、25-26 周、27-28 周、29-30 周、31-32 周和<500 克、500-749 克、750-999 克、1000-1249 克、1250-1499 克、>1500 克。定义凝血酶原时间（PT）和活化部分凝血活酶时间（aPTT）的第 3 至 97 百分位值。共纳入 420 例早产儿。婴儿的中位值和范围的胎龄和出生体重分别为 29（22.3-32.9）周和 1150（395-2790）克。根据胎龄，PT 值在亚组之间相似，但出生体重小于 1000 克的婴儿 PT 值较长。发现胎龄小于 24 周的婴儿的 aPTT 值明显较长。随着胎龄的增加，凝血系统的成熟度增加，极早产儿（<32 孕周（GW））出血风险增加。确定早产儿凝血参数的正常百分位分布将有助于解释这些婴儿的凝血参数，并最大限度地减少不必要的 FFP 给药。
