Newborn haemostasis

ABSTRACT

A study of the coagulation system of twenty full term, fifteen premature were compared to twenty normal adults receiving no medication. The fibrinogen level is proved to be normal in fullterm [274 +/- 61 mg/dl] and preterm infants [268 +/- 64 mg/ dl] when compared to the adult group [283 +/- 58 mg/dl]. Prothrombin and protein C are vitamin-K dependent proteins with important roles in haemostasis. The work showed that levels of both proteins are significantly lower than the adult and related to gestational age. Protein C level in the full term [45.6 +/- 10.2], premature [35.5 +/- 6.8] was lower than the adult [95.6 +/- 8.4] also the prothrombin level in the full term [60.4 +/- 12.9], premature [41.3 +/- 5.4] was low when compared to the adult [98.9 +/- 4.1]. A deficiency of antithrombin 111 in the newborn [59.5 +/- 14.3], preterm [41.2 +/- 12.2] is shown by comparison to the adult [89.7 +/- 10.1], the level of antithrombin III in the neonate is commensurate with the level of the vitamin K factors that it inhibits. So normally there is a delicate balance between procoagulants and inhibitors of clotting mechanism in infants. The normal ranges of the levels of prothrombin, protein C, Anti 111, total and free protein S have to be studied in later infancy and the age at which adult levels are reached need to be established