title: Impact of Thrombophilia on the Risk of Hypoxic-Ischemic Encephalopathy in Term Neonates.
abstract: BACKGROUND
  The incidence of neonatal hypoxic-ischemic encephalopathy (HIE) is reportedly high in countries with limited resources. Its pathogenesis is multifactorial. A role for thrombophilia has been described in different patterns of preterm and full-term perinatal brain injury.
  
  
  OBJECTIVE
  This study aims to identify risk factors associated with neonatal HIE and also to determine the contributions of genetic thrombophilia in the development of neonatal HIE.
  
  
  METHODS
  Sixty-seven neonates with HIE and 67 controls were enrolled in the study. Clinical history and examination were undertaken. Patients and controls were tested for the presence of factor V G1691A and prothrombin G20210A mutations. In addition, protein S, protein C, and antithrombin III levels were assessed.
  
  
  RESULTS
  Parental consanguinity and performing emergency cesarean section (CS) were significant risk factors for neonatal HIE (odds ratio [OR] 6.5, 95% confidence interval [CI] 2.6-15.3, P < .001, OR 12.6, 95% CI 2.52-63.3, P = .002, respectively). No significant difference was found regarding maternal age and parity. About 33% of cases and 6% of controls were found to have at least 1 thrombophilic factor ( P < .001). Factor V G1691A mutation significantly increased the risk of neonatal HIE (OR 4.5, 95% CI 1.4-14.5, P = .012), while prothrombin G 20210A mutation and protein C deficiency were not.
  
  
  CONCLUSIONS
  Parental consanguinity, emergency CS, and factor V mutation may contribute to the higher risk of developing neonatal HIE.
authors.affiliation: 1 Department of Pediatrics, Assiut University Children Hospital, Assiut, Egypt.
authors.forename: Nafisa H R
authors.initials: NH
authors.lastname: AbdelAziz
authors.affiliation: 2 Department of Clinical Pathology, Assiut University, Assiut, Egypt.
authors.forename: Hanan G
authors.initials: HG
authors.lastname: AbdelAzeem
authors.affiliation: 3 Department of Public Health, Assiut University, Assiut, Egypt.
authors.forename: Eman M M
authors.initials: EM
authors.lastname: Monazea
authors.affiliation: 2 Department of Clinical Pathology, Assiut University, Assiut, Egypt.
authors.forename: Tahra
authors.initials: T
authors.lastname: Sherif
mesh_terms: D001798:Blood Proteins / Q000502:physiology; D016022:Case-Control Studies; D002585:Cesarean Section; D003241:Consanguinity; D005165:Factor V / Q000502:physiology*; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000209:etiology*; D007231:Infant, Newborn; D017354:Point Mutation / Q000502:physiology; D011516:Prothrombin / Q000235:genetics*; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications*
chemical_list: D001798:Blood Proteins; C095381:factor V Leiden; D005165:Factor V; D011516:Prothrombin
keywords: neonatal hypoxic–ischemic encephalopathy; risk factors; thrombophilia