Impaired platelet activity and hypercoagulation in healthy term and moderately preterm newborns during the early neonatal period

Pediatr Res. 2019 Jan;85(1):63-71. doi: 10.1038/s41390-018-0184-8. Epub 2018 Sep 18.

Abstract

Background: Preterm newborns are at thrombohemorrhagic risk during the early neonatal period. Taking into account the lack of informative tools for the laboratory diagnosis of hemostasis disorders in newborns, our goal was to determine the baseline values of thrombodynamics and platelet functional activity in healthy term and moderately preterm newborns during the early neonatal period future potential clinical use of these tests.

Methods: Coagulation was assessed using an integral assay of thrombodynamics and standard coagulation assays, and platelet functional activity was estimated by flow cytometry.

Results: Hypercoagulation of newborns, represented by a significantly higher clot growth velocity and the presence of spontaneous clots in the thrombodynamics, was combined with platelet hypoactivity. Granule release, phosphatidylserine exposure, and the ability to change shape upon activation were decreased in the platelets of moderately preterm newborns. The platelet function remained at the same level over the first four days of life, whereas the hypercoagulation became less pronounced.

Conclusions: The hemostasis of newborns is characterized by hypercoagulation combined with reduced platelet functional activity. Moderately preterm and term newborns do not differ in the parameters of coagulation, while some of the functional responses of platelets are lower in moderately preterm newborns than in term.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Blood Coagulation*
  • Blood Platelets / metabolism*
  • Female
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Premature / blood*
  • Male
  • P-Selectin / blood
  • Phosphatidylserines / blood
  • Platelet Activation*
  • Premature Birth*
  • Term Birth
  • Thrombophilia / blood*
  • Thrombophilia / diagnosis

Substances

  • Biomarkers
  • P-Selectin
  • Phosphatidylserines
  • SELP protein, human