Neonatal Platelet Function

Sara J. Israels; Margaret L. Rand; Alan D. Michelson

doi:10.1055/s-2003-42587

Seminars in Thrombosis and Hemostasis, Table of Contents

Semin Thromb Hemost 2003; 29(4): 363-372
DOI: 10.1055/s-2003-42587

Neonatal Platelet Function

Sara J. Israels¹ , Margaret L. Rand² , Alan D. Michelson³

¹Professor,Department of Pediatrics Child Health University of Manitoba Winnipeg, Manitoba Canada
²Division of Haematology/Oncology The Hospital for Sick Children Departments of Laboratory Medicine & Pathobiology Biochemistry, University of Toronto Toronto, Ontario Canada
³Center for Platelet Function Studies Departments of Pediatrics Medicine, and Pathology University of Massachusetts Medical School Worcester, Massachusetts

Abstract

ABSTRACT

Healthy newborns maintain normal circulating platelet counts, with a platelet ultrastructure that does not differ from adults. In vitro assessments of intrinsic platelet function, however, have demonstrated transient hyporesponsiveness that is most marked in platelets from preterm infants. Decreased responses were originally considered to be the result of platelet activation and degranulation during labor and delivery, but more recent studies of platelet activation markers have not supported this theory. Decreased activation responses are due to relative deficiencies of phospholipid metabolism, calcium mobilization, granule secretion, and aggregation. These result in turn from differences in intrinsic signal transduction in the neonatal platelet compared with the adult. In contrast, there is enhanced platelet adhesion due to the presence in neonatal plasma of larger, more functionally potent von Willebrand factor multimers. These ultralarge multimers may result from decreased activity of von Willebrand factor-cleaving protease in neonatal plasma and are associated with shorter bleeding times and Platelet Function Analyser-100 closure times in neonates. In the immediate newborn period, this enhanced platelet adhesion may compensate for the decreased intrinsic platelet activation in healthy neonates, but may leave sick neonates at increased risk of bleeding.

KEYWORDS

Platelets - platelet function - neonates

Full Text

References

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