Influence of gestational age on fibrinolysis from birth to postnatal day 10.
OBJECTIVE
To compare components of the fibrinolytic cascade in newborns of gestational age ranging from extreme prematurity to full term, at birth and for the next 10 days, and in their mothers at delivery.


METHODS
We studied 10 extremely preterm neonates, 10 very preterm neonates, 10 moderately preterm neonates, 10 full-term neonates, and their mothers (n = 40). We measured the antigen levels of tissue-type plasminogen activator (t-PA), plasminogen activator inhibitors 1 (PAI-1) and 2 (PAI-2), and thrombin-activatable fibrinolysis inhibitor, as well as PAI-1 activity, in neonates at birth and on postnatal days 3 and 10 and in mothers at delivery.


RESULTS
On day 10, both PAI-1 antigen and activity were higher in extremely preterm neonates than in full-term neonates (P = .004 and <.0006, respectively), and the t-PA/PAI-1 activity ratio was lower in the extremely preterm and very preterm neonates compared with the full-term neonates (P = .002 and .017, respectively). No significant differences in the fibrinolytic system components were seen among the 4 groups of mothers.


CONCLUSIONS
The development of fibrinolysis suppression in extremely preterm infants within 10 days after birth may contribute to the increased risk of periventricular hemorrhagic infarction in these infants.
Sentilhes
Loïc
L
Department of Obstetrics and Gynecology, Rouen Institute for Medical Research and Innovation, Rouen, France. loicsentilhes@hotmail.com
Leroux
Philippe
P
Radi
Sophie
S
Ricbourg-Schneider
Aude
A
Laudenbach
Vincent
V
Marpeau
Loïc
L
Bénichou
Jacques
J
Vasse
Marc
M
Marret
Stéphane
S
D015415:Biomarkers; D025901:Carboxypeptidase B2 / Q000097:blood; D005342:Fibrinolysis / Q000502:physiology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D017396:Plasminogen Activator Inhibitor 2 / Q000097:blood; D010959:Tissue Plasminogen Activator / Q000097:blood
D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D017396:Plasminogen Activator Inhibitor 2; D025901:Carboxypeptidase B2; D010959:Tissue Plasminogen Activator