title: Developmental hemostasis: A lifespan from neonates and pregnancy to the young and elderly adult in a European white population.
abstract: Absolute values of reference ranges for coagulation assays in humans vary within the entire lifespan and confirm the concept of developmental hemostasis. It is known that physiologic concentrations of coagulation factors (F) gradually increase over age: they are lower in premature infants as compared to full-term babies, healthy children or adults. Here we demonstrate in a cohort of 1011 blood donors and in a group of 193 healthy pregnant women, that the process of developmental hemostasis proceeds in adults. During the course of pregnancy F and activation markers steadily increase until delivery with a parallel decrease noticed for protein S. From adolescents, young adults to the elderly there is a further increase of F, reaching significance starting between 35 and 50years of age compared to younger subjects. Covering the entire lifespan FVIII and von-Willebrand-factor showed the lowest values in carriers of blood group "O". Apart from pregnancy differences related to gender, pill users, smoking habits or the presence of thrombophilic variants were reported. Laboratory test results should be compared to age-related reference intervals when hemostatic defects are suspected to avoid misclassifications as being "healthy", prone to "bleeding" or vice versa to "thrombosis".
authors.affiliation: University Hospital Schleswig-Holstein, Institute of Clinical Chemistry, Thrombosis & Hemostasis Treatment Center, Campus Kiel & Lübeck, Germany. Electronic address: leagottl@uksh.de.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Nowak-Göttl
authors.affiliation: University Hospital Schleswig-Holstein, Institute of Clinical Chemistry, Thrombosis & Hemostasis Treatment Center, Campus Kiel & Lübeck, Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Limperger
authors.affiliation: Pediatric Coagulation Service, National Hemophilia Center, Institute of Thrombosis and Hemostasis, Sheba Medical Centre, Tel-Hashomer, Israel.
authors.forename: Gili
authors.initials: G
authors.lastname: Kenet
authors.affiliation: Institute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, Germany.
authors.forename: Frauke
authors.initials: F
authors.lastname: Degenhardt
authors.affiliation: University Hospital Schleswig-Holstein, Institute of Clinical Chemistry, Thrombosis & Hemostasis Treatment Center, Campus Kiel & Lübeck, Germany.
authors.forename: Roman
authors.initials: R
authors.lastname: Arlt
authors.affiliation: University Hospital Schleswig-Holstein, Institute of Clinical Chemistry, Thrombosis & Hemostasis Treatment Center, Campus Kiel & Lübeck, Germany.
authors.forename: Justus
authors.initials: J
authors.lastname: Domschikowski
authors.affiliation: University Hospital Schleswig-Holstein, Institute of Clinical Chemistry, Thrombosis & Hemostasis Treatment Center, Campus Kiel & Lübeck, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Clausnizer
authors.affiliation: University Hospital Schleswig-Holstein, Institute of Clinical Chemistry, Thrombosis & Hemostasis Treatment Center, Campus Kiel & Lübeck, Germany.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Liebsch
authors.affiliation: University Hospital Schleswig-Holstein, Institute of Clinical Chemistry, Thrombosis & Hemostasis Treatment Center, Campus Kiel & Lübeck, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Junker
authors.affiliation: Center of Blood Transfusion, University Hospital Schleswig Holstein, Kiel & Lübeck, Germany.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Steppat
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging; D001777:Blood Coagulation; D001779:Blood Coagulation Factors / Q000032:analysis*; D015331:Cohort Studies; D005060:Europe; D005169:Factor VIII / Q000032:analysis; D005260:Female; D006487:Hemostasis; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D012737:Sex Factors; D055815:Young Adult; D014841:von Willebrand Factor / Q000032:analysis
chemical_list: D001779:Blood Coagulation Factors; D014841:von Willebrand Factor; D005169:Factor VIII