Intraventricular haemorrhage in very-low-birthweight preterm infants: association with low prothrombin activity at birth.
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.
Salonvaara
Marjut
M
Department of Paediatrics, Kuopio University Hospital, Kuopio University, Finland. marjut.salonvaara@finmet.fi
Riikonen
Pekka
P
Kekomäki
Riitta
R
Vahtera
Elina
E
Mahlamäki
Eija
E
Kiekara
Olan
O
Heinonen
Kirsti
K
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*
D011516:Prothrombin