Sofie Taageby Nielsen, Denmark
Rigshospitalet Clinical BiochemistryPresenter of 1 Presentation
Thrombosis and hemostasis parameters in early life – The Copenhagen Baby Heart and COMPARE studies
Abstract
Background and Aims
The neonatal coagulation system is not fully developed at birth. Reliable reference values in newborns and during early childhood are not well described, complicating clinical decision making within thrombosis and hemostasis. The aim of this study is to evaluate values of coagulation parameters at birth and two months after birth, and to test whether cord blood measurements can be used as proxy for neonatal venous blood measurements.
Methods
The Copenhagen Baby Heart and COMPARE studies comprise 13,000 cord blood samples and 450 parallel venous neonatal blood samples, with a two-month follow-up in 200 children.
Results
At birth, medians in girls and boys were 32 s and 33 s for Activated Partial Thromboplastin Time (APTT), 1.4 and 1.4 for International Normalized Ratio (INR), 47% and 45% for factor II+VII+X, and 314×109/L and 300×109/L for thrombocytes. Two months after birth, corresponding values were 30 s and 31 s for APTT, 1.1 and 1.1 for INR, 77% and 83% for factor II+VII+X, and 493×109/L and 452×109/L for thrombocytes. Correlation coefficients between cord blood and neonatal venous blood were 0.7 for APTT, INR, and factor II+VII+X, and 0.8 for thrombocytes.
Conclusions
Coagulation parameters are not as extreme at birth as previously reported and are close to adult values two months after birth. Further, for these parameters cord blood can be used as proxy for neonatal venous blood. The present data has the potential to form the scientific basis for well-defined age- and sex-dependent reference intervals, improving clinical decision making within thrombosis and hemostasis.