Coagulation Parameters in Maternal and Cord Blood at Delivery

Abstract

A wide range of hemostatic variables were studied in 300 maternal/neonatal pairs at the time of delivery and also in 375 healthy nonpregnant women who served as controls. There was significant prolongation of the prothrombin time, partial thromboplastin time, and reptilase time in neonatal (cord) blood compared to maternal blood. The plasma levels of fibrinogen, antithrombin III, protein C, plasminogen, factor VIII coagulant and ristocetin cofactor activities, factor X, and platelet counts were significantly lower in neonatal than maternal plasma. In contrast, the thrombin time, alpha2-antiplasmin, and serum fibrin degradation products showed comparable values for both mothers and neonates. von Willebrand factor antigen showed a more significant elevation in mothers than neonates; however, the ratio of von Willebrand factor antigen/factor VIII coagulant was similar in both (1.56 and 1.57, respectively). There was a significant correlation only between factor VIII coagulant levels in mothers and their babies (r = 0.69; P < 0.05) but not for the other hemostatic variables studied. The differences between our results and those reported in smaller published studies are discussed.

Adsorption of proteins from infant and adult plasma to biomaterial surfaces

“…As indicated above, the newborn period is characterized by low levels of a number of proteins, [15][16][17][18][19] and this may be a factor in the relatively low adsorption seen from infant plasma. The absolute quantities adsorbed are in the range of 2-6 g/cm 2 , corresponding to approximately 1 to 3-5 monolayers.…”

“…15,17,18,22,23 The four contact factors (factor XI, factor XII, prekallikrein, and HMWK) are low at birth. 15,16,19,23 HMWK levels approach adult values within the first month of life while factors XI, XII, and prekallikrein show a gradual increase, approaching the adult range at 6 months of age. 15,17 Plasminogen levels also are low at birth and show a gradual increase, reaching close to adult values at 6 months.…”

“…[10][11][12][13][14] Data reported in the literature indicate a number of differences in the hemostatic systems between newborns and adults. [15][16][17][18][19][20][21][22][23] In general, screening tests (PT, APTT) are prolonged in the newborn infant. 15,17,18,22,23 The four contact factors (factor XI, factor XII, prekallikrein, and HMWK) are low at birth.…”