Abstract
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.
Keywords
neonates - perinatal hypoxia - fetal distress - coagulopathy - thromboelastometry
