Coagulation profiles are associated with early clinical outcomes in neonatal encephalopathy

Thumbnail Image
fped-07-00399.pdf(629.38 KB)
Published version
Sweetman, Deirdre
Kelly, Lynne A.
Zareen, Zunera
Nolan, Beatrice
Murphy, John
Boylan, Geraldine B.
Donoghue, Veronica
Molloy, Eleanor J.
Journal Title
Journal ISSN
Volume Title
Frontiers Media S.A.
Published Version
Research Projects
Organizational Units
Journal Issue
Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04). Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality.
Coagulopathy , Neonatal encephalopathy (NE) , Hypoxic-ischaemic encephalopathy , EEG , MRI
Sweetman, D., Kelly, L. A., Zareen, Z., Nolan, B., Murphy, J., Boylan, G., Donoghue, V. and Molloy, E. J. (2019) 'Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy', Frontiers in Pediatrics, 7, 399. (7pp.) doi: 10.3389/fped.2019.00399
Link to publisher’s version