Thromboelastometry: studying hemostatic profile in small for gestational age neonates—a pilot observational study
Scarce data exists about the hemostatic status of small for gestational age (SGA) neonates. We aimed at evaluating the hemostatic profile of SGA neonates, using thromboelastometry (TEM). This is an observational study performed in a Greek tertiary General Hospital during an 18-month period. Ninety-three neonates were included in the study: 48 appropriate for gestational age weight (AGA) neonates and 45 SGA neonates Extrinsically activated TEM (ex-TEM) parameters, such as clotting time, clot formation time, amplitude recorded at 5 and 10 min, a angle, maximum clot firmness, lysis index at 60 min, and also platelet count, were used for the evaluation of the hemostatic profile in all neonates. No statistically significant differences were noticed regarding all ex-TEM parameters between AGA and SGA neonates, while no event of hemorrhage or thrombosis was noticed in the study population.
What is Known:
• SGA neonates may present coagulation disorders mainly due to hepatic dysfunction, polycythemia, and thrombocytopenia owing to long-term intrauterine hypoxia.
• In the literature, despite the statistically significant differences in laboratory results between SGA and AGA neonates, no clinical manifestations of significantly altered hemostasis were recorded. Data of TEM interpretation of hemostasis in SGA neonates are not available.
What is New:
• TEM seems to interpret coagulation mechanism of preterm and full-term SGA neonates and confirm previous relevant literature findings regarding hemostasis in these neonates.
KeywordsHemostasis SGA neonates Thromboelastometry Coagulation system Coagulation disorders
- A5, A10
Amplitude recorded at 5 and 10 min
Appropriate for gestational age
Activated protein C resistance
Activated partial thromboplastin time
Clot formation time
Day of life
Extrinsically activated TEM
International normalized ratio
Lysis index at 60 min
Maximum clot firmness
Nasal continuous positive airway pressure
Neonatal Intensive Care Unit
Plasminogen activator inhibitor-1
Pressure positive end-expiratory pressure
Small for gestational age
Tissue plasminogen activator
RS, AK, and AT contributed to the conception and design of the study. RS, AK, SP, KL, GK, EK, and ET conducted the work and collected the data. A.G.T, AK, CS, RS, and SB carried out the statistical analysis. All authors contributed to the interpretation of data for the work. RS, AK, AT, SP, NI, AG, and SB drafted the manuscript. All authors critically revised the paper for important intellectual content and approved the final version to be published.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
For this type of study, formal consent is not required.
The study was conducted in agreement with the Helsinki Declaration. Ethical approval was obtained from the Research Ethics Committee of the General Hospital of Nikaia-Piraeus “Aghios Panteleimon” (15.07.2014, 32/3).
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