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Intraventricular haemorrhage in very‐low‐birthweight preterm infants: Association with low prothrombin activity at birth
Author(s) -
Salonvaara Marjut,
Riikonen Pekka,
Kekomäki Riitta,
Vahtera Elina,
Mahlamäki Eija,
Kiekara Olan,
Hein Kirsti
Publication year - 2005
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2005.tb01989.x
Subject(s) - medicine , gestational age , neonatal intensive care unit , intraventricular hemorrhage , gestation , prothrombin time , low birth weight , birth weight , pediatrics , obstetrics , apgar score , pregnancy , gastroenterology , genetics , biology
Aim: To determine the occurrence of intraventricular haemorrhage (IVH) and its association with coagulation factors at birth in preterm neonates born before 30 wk gestation. Methods: 38 neonates (median gestational age 27 wk, range 24–29 wk; median birthweight (BW) 933 g, range 515–1760 g) admitted to the neonatal intensive care unit were studied. Blood samples for coagulation factors were taken within 2 h after birth. The first cranial ultrasonographic examination was performed within the first 3 d. The occurrence of IVH was tested statistically by the Mann‐Whitney U‐test for association with the activity of coagulation factors and clinical variables. Results: Thirteen IVHs occurred within the first 3 d of life. IVH was associated with BW <1000 g ( p =0.012), low mean blood pressure within the first 2 d ( p =0.026), gestational age <27 wk ( p =0.054), low Apgar scores (<7) at 1 min ( p =0.078) and intrauterine growth restriction ( p =0.072). At birth (samples drawn with a median of first 36 min of life), infants with subsequent IVH had statistically significantly lower prothrombin (factor II) activity ( p =0.024) than infants without IVH. Conclusion: The measured low prothrombin may have been affected by a prior bleeding event. Nevertheless, preterm infants with low prothrombin activity may be susceptible to IVH, or to the progression of it, if left undiagnosed.