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DECREASED FIBRINOGEN LEVELS ASSOCIATED WITH SEVERE INTRAVENTRICULAR HAEMORRHAGE IN VERY LOW BIRTHWEIGHT (VLBW) INFANTS
  1. M White1,
  2. T O'Carroll1,
  3. A Twomey1,
  4. J F A Murphy1,
  5. E J Molloy1
  1. 1Department of Neonatology, National Maternity Hospital, Holles Street, Dublin, Ireland

Abstract

Background Reference ranges for coagulation screens in healthy preterm infants were formulated in the 1980s. Preterm infants are at risk of hypocoagulable states for a number of reasons – mild degrees of hypoxia or respiratory distress syndrome can affect levels of coagulation factors and sepsis is a major risk factor for coagulation abnormalities.

Aims This retrospective study aimed to assess coagulation profiles of very low birthweight (VLBW) infants in our tertiary centre and to determine if abnormalities in coagulation screens were associated with adverse outcomes in our population.

Methods All coagulation screens performed on VLBW infants 2005–7 were documented. Serial cranial ultrasound results were obtained from the VLBW database.

Results 290 VLBWs were admitted during the study period. 105 coagulation screens were performed on 54 babies ⩽1500 g (19 unsuitable for analysis; 86 analysed). Profiles were available for 40 infants; prothrombin time (PT), international normalised ratio (INR), activated partial thromboplastin time (APTT), and fibrinogen. Gestational ages were significantly lower in those with Grade 3–4 IVH (27±2.3 versus 25.6±2.1; p<0.05). Fibrinogen levels day 1/2 were not significant between the groups, but a difference was seen on day 3 (see table). No other comparisons were significant.

Discussion Fibrinogen levels day 1 were not significant, but by day 3 low fibrinogen was associated with increased incidence of severe IVH. This emphasises the need for further research on VLBW coagulation profiles and if and when treatment is warranted.

White et al Coagulation values in VLBW on Day 3 of life

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