Hemostatic Parameters in Newborn - II. Sequential Study During the First Four Weeks of Life

Summary

A sequential study of kaolin cephalin clotting time (KCCT), prothrombin time (PT), thrombin time (TT), plasma fibrinogen and serum FDP was conducted during the first four weeks of life on term and preterm babies. A “physiological dip” of PT and TT was noted inappropriate for gestational age (AGA) babies both term and preterm; in case of KCCT, the dip was significant in term AGA babies only. At the end of four weeks, PT and TT had moderately improved in term babies but showed little improvement in preterm ones; KCCT reached almost an adult value in all babies except in preterm AGA and term LGA (large for gestational age) ones. Plasma fibrinogen showed no “physiological dip” and reached adult level in two to four weeks. Serum FDP levels were appreciably raised in preterm AGA babies only at birth and there too normalised by 72 h.

Key words

Neonate - Preterm - Term - SGA - AGA - LGA - Blood coagulation - Hemostasis

• References

• 1 Jensen AH B, Josso F, Zamet P, Couchard MM, Minkowski A. Evolution of blood clotting factor levels in premature infants during the first 10 days of life: A study of 96 cases with comparison between clinical status and blood clotting factor levels. Pediat Res 1973; 7: 638-644
• 2 Ekelund H, Hedner U, Nilsson IM. Fibrinolysis in newborns. Acta Paediat Scand 1970; 59: 33-43
• 3 Kazal LA. Congenital disorders of hemostasis and blood coagulation in infancy. In: The clinical pathology of infancy Sunderman FW, Sunderman jr FW. (Eds) Charles C Thomas; Springfield III: 1967: 103-117
• 4 Kurkcouglu M, McElfresh AE. The Hageman factor: Determinations of its concentration during the neonatal period and presentation of a case of Hageman factor deficiency. J Pediatr 1960; 57: 61-64
• 5 Barnard DR, Simmons MA, Hathaway WE. Coagulation studies in extremely premature infants. Pediat Res 1979; 13: 1330-1335
• 6 Dube B, Dube RK, Bhargava V, Kolindewala JK, Kota VL N, Das BK. Hemostatic parameters in newborns. I. Effect of gestation and rate of intrauterine growth. Thromb Haemostas 1986; 55: 47-50
• 7 Cade JF, Hirsh J, Martin M. Placental barrier to coagulation factors, its relevance to the coagulation defect at birth and to haemorrhage in the newborn. Br Med J 1969; 2: 281-283
• 8 Aballi AJ, Delamerens S. Coagulation changes in the neonatal period and in early infancy. Pediatr Clin North Am 1962; 9: 785 (quoted by Cade et al, 1969)
• 9 Witt I, Müller H, Künzer W. Evidence of existence of foetal fibrinogen. Thrombos Diathes Haemorrh 1969; 22: 101-109
• 10 Hilgartner MW, Smith CH. Plasma thromboplastin antecedent (Factor XI) in the neonate. J Pediatr 1965; 66: 747-752