title: Intraventricular haemorrhage in very-low-birthweight preterm infants: association with low prothrombin activity at birth.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Paediatrics, Kuopio University Hospital, Kuopio University, Finland. marjut.salonvaara@finmet.fi
authors.forename: Marjut
authors.initials: M
authors.lastname: Salonvaara
authors.forename: Pekka
authors.initials: P
authors.lastname: Riikonen
authors.forename: Riitta
authors.initials: R
authors.lastname: Kekomäki
authors.forename: Elina
authors.initials: E
authors.lastname: Vahtera
authors.forename: Eija
authors.initials: E
authors.lastname: Mahlamäki
authors.forename: Olan
authors.initials: O
authors.lastname: Kiekara
authors.forename: Kirsti
authors.initials: K
authors.lastname: Heinonen
mesh_terms: D002543:Cerebral Hemorrhage / Q000097:blood* / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D011516:Prothrombin / Q000032:analysis*
chemical_list: D011516:Prothrombin