Abstract
Endothelium derived substances may play a role in the physiological adaptation processes
at the time of birth. The aim of this study was to investigate plasma concentrations
of activation markers of the endothelium (endothelin-1, thrombomodulin, von Willebrand
factor), of the coagulation and the fibrinolytic systems (thrombin-antithrombin III
complex, D-dimer, plasmin-alpha2-antiplasmin complex) during the first days of life. Venous blood from peripheral
veins was collected from 79 healthy newborns and for comparison from 38 healthy infants
and schoolchildren, as well as from 17 healthy adults. Except for endothelin and von
Willebrand factor, the concentrations of activation markers were significantly higher
in the newborn group. During the first 12 days of life thrombomodulin, thrombin-antithrombin
III complex, and plasmin-alpha2-antiplasmin complexes showed a continuous decline whereas the concentrations of endothelin,
von Willebrand factor and D-dimer did not change. The highest D-dimer concentrations
were found at low umbilical arterial pH and after birth by vaginal operation suggesting
an influence of birth stress. Thrombomodulin was correlated with endothelin (r = +0.471)
and with von Willebrand factor (r = -0.415). In conclusion, endothelial, coagulation,
and fibrinolytic systems are activated in newborns which might occur during birth
by the mechanical stress, the adaptation of circulation, and the short-term hypoxic
state. An additional intrauterine activation should also be considered.
Keywords:
Activation markers - endothelium - hemostasis - newborns - TAT - PAP - D-dimer
