Coagulation profiles are associated with early clinical outcomes in neonatal encephalopathy
Kelly, Lynne A.
Boylan, Geraldine B.
Molloy, Eleanor J.
Frontiers Media S.A.
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
©2019 Sweetman, Kelly, Zareen, Nolan, Murphy, Boylan, Donoghue and Molloy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.