Semin Thromb Hemost 2020; 46(04): 428-434
DOI: 10.1055/s-0040-1709473
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Thromboelastometry Variables in Neonates with Perinatal Hypoxia

Aikaterini Konstantinidi
1  Neonatal Intensive Care Unit, Nikaia General Hospital “Aghios Panteleimon,” Piraeus, Greece
Rozeta Sokou
1  Neonatal Intensive Care Unit, Nikaia General Hospital “Aghios Panteleimon,” Piraeus, Greece
Andreas G. Tsantes
2  First Department of Orthopaedics, National & Kapodistrian University of Athens School of Medicine, Attikon University Hospital, Athens, Greece
Stavroula Parastatidou
1  Neonatal Intensive Care Unit, Nikaia General Hospital “Aghios Panteleimon,” Piraeus, Greece
Stefanos Bonovas
3  Department of Biomedical Sciences, Humanitas University, Milan, Italy
4  Humanitas Clinical and Research Center, Milan University, Milan, Italy
Evaggelia Kouskouni
5  Biopathology Laboratory, National & Kapodistrian University of Athens Medical School, Aretaieion Hospital, Athens, Greece
Antonios K. Gounaris
6  Neonatal Intensive Care Unit, University Hospital of Larissa, Larissa, Greece
Argyrios E. Tsantes
7  Laboratory of Haematology and Blood Bank Unit, National & Kapodistrian University of Athens School of Medicine, “Attiko” Hospital, Athens, Greece
Nicoletta Iacovidou
8  Neonatal Department, National and Kapodistrian University of Athens School of Medicine, Aretaieion Hospital, Athens, Greece
› Author Affiliations
Funding The authors did not receive, for this research, any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Further Information

Publication History

Publication Date:
21 May 2020 (online)


Perinatal hypoxia is associated with an increased risk of coagulation disorders by enhancing the consumption of platelets and some clotting factors due to the associated severe hypoxemia, acidemia, and compromised oxygen and blood supply to the neonatal liver and bone marrow. Thromboelastometry (TEM), which estimates the dynamics of blood coagulation, may represent an attractive tool for studying the coagulation status of these neonates. We aimed at assessing the hemostatic profile of neonates with perinatal hypoxia using the standard extrinsically activated TEM (ex-TEM) assay. In total, 164 hospitalized neonates with perinatal asphyxia and/or fetal distress comprised the study subjects, and 273 healthy neonates served as controls. Ex-TEM assay was performed, SNAPPE (Score for Neonatal Acute Physiology Perinatal Extension) was calculated, and clinical findings and laboratory results were recorded in all study subjects. Hypoxic neonates expressed a prolonged clotting time (CT) and clot formation time (CFT) and reduced amplitude at 10 minutes (A10), α-angle, and maximum clot firmness compared with healthy neonates. Furthermore, asphyxiated neonates had a significantly prolonged CT and CFT and reduced A10 and α-angle compared with neonates with fetal distress. Hypoxic neonates demonstrate a hypocoagulable ex-TEM profile relative to healthy neonates, indicating a potential role of TEM in the early detection of coagulation derangement in perinatal hypoxia.

Authors' Contributions

A. K., R. S., and N. I. contributed to the conception and design of the study. A. K. and R. S. conducted the work and collected the data. A. G. T., A. K., R. S., and S. B. performed the statistical analysis. All authors contributed to the interpretation of data for the work. A. K., R. S., A. E. T., S. P., E. K., A. K. G., and N. I. drafted the manuscript. All authors critically revised the paper for important intellectual content and approved the final version to be published.