Coagulation profiles are associated with early clinical outcomes in neonatal encephalopathy

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dc.contributor.authorSweetman, Deirdre
dc.contributor.authorKelly, Lynne A.
dc.contributor.authorZareen, Zunera
dc.contributor.authorNolan, Beatrice
dc.contributor.authorMurphy, John
dc.contributor.authorBoylan, Geraldine B.
dc.contributor.authorDonoghue, Veronica
dc.contributor.authorMolloy, Eleanor J.
dc.contributor.funderNational Children's Research Centreen
dc.contributor.funderRoyal College of Surgeons in Irelanden
dc.date.accessioned2019-12-04T10:01:17Z
dc.date.available2019-12-04T10:01:17Z
dc.date.issued2019-10-01
dc.description.abstractIntroduction: 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.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid399en
dc.identifier.citationSweetman, 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.2019.00399en
dc.identifier.doi10.3389/fped.2019.00399en
dc.identifier.eissn2296-2360
dc.identifier.endpage7en
dc.identifier.journaltitleFrontiers in Pediatricsen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/9311
dc.identifier.volume7en
dc.language.isoenen
dc.publisherFrontiers Media S.A.en
dc.rights©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.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectCoagulopathyen
dc.subjectNeonatal encephalopathy (NE)en
dc.subjectHypoxic-ischaemic encephalopathyen
dc.subjectEEGen
dc.subjectMRIen
dc.titleCoagulation profiles are associated with early clinical outcomes in neonatal encephalopathyen
dc.typeArticle (peer-reviewed)en
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