The Bleeding Infant

Abstract

A rare complication in infants is an increased bleeding tendency. The incidence of bleeding in infants is not well known and depends very much on the age of gestation and which symptoms are considered. The human haemostatic system is dynamic and largely influenced by age. It is considered immature in the newborn, however it is a physiological system which results in few problems in the term neonate. In the preterm and sick neonate the haemostatic system can be largely out of balance and as a result cause a high bleeding tendency. Many of the procoagulants, anticoagulants and proteins involved in the haemostatic system are dependent on the age of gestation. The new-born’s haemostatic system matures in the weeks after delivery to become fully mature after 6 months. The preterm infant has much lower values, although they appear to normalise after delivery in the same 6 months period. It is important to realise this agedependent changes and for the most important coagulation tests and clotting factors they can be found in Table 1. Data on haemostatic values in healthy neonates are scarce, the data in this chapter originate from the studies performed by Dr Andrew [1],[2].