Hemostatic profile in healthy premature neonates; does birth weight affect the coagulation profile?

CONTEXT: There are limited studies assessing the neonatal hemostatic factors in relation to birth weight.

AIMS: This study aims to compare the coagulation factors between three groups of neonates with different birth weight for gestational age (GA).

SETTINGS AND DESIGN: In a cross-sectional study, 74 healthy premature neonates were involved.

SUBJECTS AND METHODS: Serum prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), thrombin clotting time (TT), and levels of fibrinogen, anti-thrombin III, protein S and protein C were measured. Neonates were classified into three groups according to birth weight, including small, appropriate and large for gestational age (SGA, AGA, and LGA).

STATISTICAL ANALYSIS USED: Statistical analysis was performed using SPSS software.

RESULTS: There was a significant difference in the levels of protein S (P < 0.001), protein C (P = 0.004), and values of APTT (P = 0.01) between three groups. Other coagulation factors however, did not represent a significant pattern (P > 0.05). Protein S concentration, directly (B = 0.78, P < 0.001), and APTT, inversely (B = -0.29, P = 0.03), associated with birth weight after adjustment for GA and sex.

CONCLUSIONS: Despite the decrease in APTT from SGA to AGA, and LGA neonates, levels of protein S increases directly with birth weight. However, no other coagulation factors revealed an explainable pattern in relation to the state of SGA, AGA, or LGA.