Abstract
Intraventricular hemorrhage (IVH) affects up to 22% of extremely low birth weight
neonates. Impaired coagulation might contribute to the pathogenesis of IVH. The aims
of this study were to summarize the current knowledge on the role of platelet indices
in premature neonates with IVH and to provide an overview of secondary hemostasis
parameters as well as fibrinolysis in premature neonates with IVH. The review was
conducted in accordance with the Preferred Reporting Items for Systematic Reviews
and Meta-Analyses (PRISMA) guidelines. The databases PubMed, Embase, Scopus, and Web
of Science were searched on March 7, 2019, without time restrictions. In total, 30
studies were included. Most studies investigated the significance of platelet counts
and/or mean platelet volume (MPV). The meta-analysis showed that at day 1 of life,
neither platelet count nor MPV differed significantly between neonates with or without
IVH (standardized mean difference [SMD]: –0.15 × 109/L, 95% confidence interval [CI]: –0.37 to 0.07 and SMD: 0.22 fl, 95% CI: –0.07 to
0.51, respectively). However, platelet counts < 100 × 109/L were associated with an increased risk of IVH. Secondary hemostasis parameters
did not differ between neonates with and without IVH. Fibrinolysis was only sparsely
investigated. In conclusion, platelet counts < 100 × 109/L were associated with an increased risk of IVH in premature neonates. The impact
of secondary hemostasis was only sparsely investigated but seemed to be minor, and
the role of fibrinolysis in IVH in premature neonates needs further research. Whether
reduced platelet function is associated with an increased risk of IVH in premature
neonates remains to be investigated.
Keywords
intraventricular hemorrhage - premature neonates - platelet - blood coagulation tests
- fibrinolysis
