Houben Nina, Fustolo-Gunnink Suzanne, Caram-Deelder Camila, Visser Remco, Bosma Madeleen, Fijnvandraat Karin, Eikenboom Jeroen, van der Bom Johanna, Lopriore Enrico
Division of Neonatology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
Sanquin Research, Sanquin Blood Supply Foundation, Amsterdam, the Netherlands.
Vox Sang. 2025 Jan;120(1):55-62. doi: 10.1111/vox.13766. Epub 2024 Nov 18.
Routine coagulation screens at birth are still standard in some European neonatal intensive care units (NICUs), although interpretation of these results is complex in preterm infants. It is unclear to what extent local coagulation assay results agree with published reference ranges when using different analysers and reagents. We aimed to assess coagulation assay results on day 1 of life in very preterm infants admitted to the NICU.
We included all preterm infants born below 32 weeks gestational age (GA) admitted to the Leiden University Medical Center between 2004 and 2020 in whom coagulation assays (prothrombin time [PT] and activated partial thromboplastin time [APTT]) were obtained during the first 24 h of life. Infants either diagnosed with major intraventricular haemorrhage or who received plasma transfusion before coagulation assay were excluded. We assessed coagulation assay results and compared the results between <28 weeks (extremely preterm) and 28-32 weeks (very preterm) GA groups.
Coagulation assays were obtained at birth in 144 infants (144/2577; 5.5%) of whom 104 fulfilled the inclusion criteria. We found similar median PT and APTT values for extremely and very preterm infants (PT: 18.1 vs. 18.7 s [p-value = 0.400]; APTT: 44.2 vs. 47.7 s [p-value = 0.252], respectively).
We found similar coagulation assay results at birth for extremely and very preterm infants; however, results deviated considerably from some of the published reference ranges. This may be due to differences between analysers and reagents, underlining the need for reference ranges calibrated to the equipment used per NICU.
在一些欧洲新生儿重症监护病房（NICU），出生时进行常规凝血筛查仍是标准做法，尽管对早产儿来说，这些结果的解读很复杂。使用不同分析仪和试剂时，尚不清楚当地凝血检测结果与已发表的参考范围在多大程度上相符。我们旨在评估入住NICU的极早产儿出生第1天的凝血检测结果。
我们纳入了2004年至2020年间入住莱顿大学医学中心、胎龄小于32周的所有早产儿，这些婴儿在出生后24小时内进行了凝血检测（凝血酶原时间[PT]和活化部分凝血活酶时间[APTT]）。排除在凝血检测前被诊断为重大脑室内出血或接受过血浆输注的婴儿。我们评估了凝血检测结果，并比较了胎龄<28周（极早产儿）和28 - 32周（早产儿）组之间的结果。
144名婴儿（144/2577；5.5%）在出生时进行了凝血检测，其中104名符合纳入标准。我们发现极早产儿和早产儿的PT和APTT中位数相似（PT：分别为18.1秒对18.7秒[p值 = 0.400]；APTT：分别为44.2秒对47.7秒[p值 = 0.252]）。
我们发现极早产儿和早产儿出生时的凝血检测结果相似；然而，结果与一些已发表的参考范围有很大偏差。这可能是由于分析仪和试剂之间的差异，强调了需要根据每个NICU使用的设备校准参考范围。
