Thromboelastometry Variables in Neonates with Perinatal Hypoxia

Abstract

Perinatal hypoxia is associated with an increased risk of coagulation disorders by enhancing the consumption of platelets and some clotting factors due to the associated severe hypoxemia, acidemia, and compromised oxygen and blood supply to the neonatal liver and bone marrow. Thromboelastometry (TEM), which estimates the dynamics of blood coagulation, may represent an attractive tool for studying the coagulation status of these neonates. We aimed at assessing the hemostatic profile of neonates with perinatal hypoxia using the standard extrinsically activated TEM (ex-TEM) assay. In total, 164 hospitalized neonates with perinatal asphyxia and/or fetal distress comprised the study subjects, and 273 healthy neonates served as controls. Ex-TEM assay was performed, SNAPPE (Score for Neonatal Acute Physiology Perinatal Extension) was calculated, and clinical findings and laboratory results were recorded in all study subjects. Hypoxic neonates expressed a prolonged clotting time (CT) and clot formation time (CFT) and reduced amplitude at 10 minutes (A10), α-angle, and maximum clot firmness compared with healthy neonates. Furthermore, asphyxiated neonates had a significantly prolonged CT and CFT and reduced A10 and α-angle compared with neonates with fetal distress. Hypoxic neonates demonstrate a hypocoagulable ex-TEM profile relative to healthy neonates, indicating a potential role of TEM in the early detection of coagulation derangement in perinatal hypoxia.

Keywords

neonates - perinatal hypoxia - fetal distress - coagulopathy - thromboelastometry

Authors' Contributions

A. K., R. S., and N. I. contributed to the conception and design of the study. A. K. and R. S. conducted the work and collected the data. A. G. T., A. K., R. S., and S. B. performed the statistical analysis. All authors contributed to the interpretation of data for the work. A. K., R. S., A. E. T., S. P., E. K., A. K. G., and N. I. drafted the manuscript. All authors critically revised the paper for important intellectual content and approved the final version to be published.

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