The impact of intrauterine growth on coagulation and factor XII function in preterm infants.

Abstract

This study aims to examine the impact of intrauterine growth restriction (IUGR) on coagulation in preterm newborns and assess the administration of fresh frozen plasma. The study involved 30 preterm infants with IUGR and 32 preterm infants without it. Blood samples were collected within 4 h after birth to analyze blood gases, complete blood counts, renal and liver function tests, and coagulation factors. Differences between the two groups were assessed using SPSS version 15. IUGR significantly impacts coagulation in infants born before the 32nd week of gestation. Preterm infants with IUGR, specifically those born before 32 weeks, show notably lower levels of coagulation factors V, VII, XIII, and antithrombin III. Additionally, they have higher levels of factor VIII and longer thromboplastin times. The coagulation effects are less pronounced in infants born at or after 32 weeks of gestation than those born before 32 weeks. Moreover, factor XII levels are significantly higher in all preterm infants with IUGR. Preterm infants with intraventricular hemorrhage have prolonged prothrombin time and activated partial thromboplastin time, and their coagulation factor levels differ significantly. Conventional coagulation tests may not reliably predict bleeding tendencies in preterm infants with IUGR. However, these tests help assess the risk of intraventricular hemorrhage in preterm babies. Infants born before 32 weeks of gestation often have lower levels of coagulation factors because of growth restriction, which makes the administration of fresh frozen plasma a reasonable option in cases of bleeding for this population. Additionally, factor XII levels may provide insight into conditions related to hypoxia and inflammation, including IUGR.