2nd Neonatal Department and Neonatal Intensive Care Unit (NICU), Aristotle University of Thessaloniki, "Papageorgiou" Hospital, Thessaloniki, PC, Greece.
2nd Department of Pathology, National and Kapodistrian University of Athens, "Attikon" University Hospital, Athens, PC, Greece.
J Perinat Med. 2024 Feb 7;52(3):327-342. doi: 10.1515/jpm-2023-0444. Print 2024 Mar 25.
During pregnancy, severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection may intensify the gestational procoagulant state. Coronavirus disease 2019 (COVID-19) associated coagulopathy (CAC) constitutes an exacerbated immunothrombosis response. There is limited data regarding the coagulation profile of SARS-CoV2-infected pregnant women, especially those with CAC, and the effect on their offspring. This prospective study aimed to compare the hemostatic profile of those women and their neonates with healthy mother-neonate pairs.
Conventional coagulation tests (CCTs) and rotational thromboelastometry (ROTEM) were employed to evaluate the hemostatic profiles. Neonates were assessed at birth and on the fourth day of life.
We enrolled 46 SARS-CoV2-infected pregnant women and 22 healthy controls who gave birth to 47 and 22 neonates, respectively. CAC was present in 10 participants. SARS-CoV2-infected pregnant women manifested slightly prolonged APTT and higher fibrinogen levels. Regarding ROTEM, we noted decreased FIBTEM CFT, with higher A10, A-angle, and MCF. The CAC group presented lower platelet count, increased fibrinogen levels, and higher FIBTEM A10 and MCF. PT was slightly prolonged at birth in neonates born to SARS-CoV2-infected mothers. During the fourth day of life, D-dimers were significantly increased. Concerning ROTEM, neonates born to SARS-CoV2-infected mothers showed lower FIBTEM CT at birth.
SARS-CoV2-infected pregnant women present a hypercoagulable profile. Hypercoagulability with elevated fibrinolysis and lower platelet count is observed in participants with CAC. The coagulation profile of neonates born to SARS-CoV2 mothers seems unaffected. Elevated D-dimers on the fourth day may reflect a neonatal inflammatory response to maternal SARS-CoV2.
在妊娠期间，严重急性呼吸综合征冠状病毒 2（SARS-CoV2）感染可能会加剧妊娠促凝状态。新型冠状病毒病 2019（COVID-19）相关的凝血障碍（CAC）构成了一种加剧的免疫血栓反应。关于 SARS-CoV2 感染孕妇的凝血谱，尤其是那些伴有 CAC 的孕妇及其后代的凝血谱，数据有限。本前瞻性研究旨在比较这些女性及其新生儿与健康母婴对的止血谱。
采用常规凝血试验（CCT）和旋转血栓弹性测定法（ROTEM）评估止血谱。新生儿在出生时和出生后第 4 天进行评估。
我们纳入了 46 名 SARS-CoV2 感染孕妇和 22 名健康对照者，他们分别产下了 47 名和 22 名新生儿。10 名参与者存在 CAC。SARS-CoV2 感染孕妇的 APTT 略有延长，纤维蛋白原水平升高。关于 ROTEM，我们发现 FIBTEM CFT 降低，A10、A-角和 MCF 升高。CAC 组血小板计数较低，纤维蛋白原水平升高，FIBTEM A10 和 MCF 升高。母亲感染 SARS-CoV2 的新生儿出生时 PT 略有延长。出生后第 4 天，D-二聚体明显升高。关于 ROTEM，母亲感染 SARS-CoV2 的新生儿出生时 FIBTEM CT 较低。
SARS-CoV2 感染孕妇表现出高凝状态。伴有纤维蛋白溶解升高和血小板计数降低的高凝状态见于 CAC 患者。母亲感染 SARS-CoV2 的新生儿的凝血谱似乎未受影响。第 4 天 D-二聚体升高可能反映了新生儿对母亲 SARS-CoV2 的炎症反应。
