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Abstract the haemostatic system is a complex interaction between the vasculature, cellular components and plasma proteins that interact to maintain haemostasis in the healthy body. There are various substances required for proper functioning of coagulation including vitamin K, which is required for the synthesis of factors II, VII, IX, X as well as protein C, protein S and protein Z that are important proteins involved in regulation of the coagulation process. Preterm birth refers to the birth of a baby of less than 37weeks gestational age. The cause for preterm birth is in manysituations elusive and unknown.Evaluation of haemostasis in neonates requires a different approach from that in older children and adults. This results in normal values for routine coagulation tests that are outside thestandard laboratory reference ranges, often making interpretation difficult, especially in extreme preterm infants. The purpose of this study was to investigate the vit- k dependent coagulation factors of premature infants at birth and to assess the effects of prenatal and perinatal events on the coagulation status. In our study 45 Egyptian preterm babies were enrolled in this study and were divided into three groups. The first group (group I) was composed of 15 preterm neonates their age between 26 to 31 weeks. The second group (group II) was composed of 15 preterm neonates their age ranged from32 to 34 weeks. The third group (group III) was composed of 15 preterm neonates their age ranged from35 to 36 weeks. Also the study included 20 healthy full term neonates their age above 36. In the present study there was a highly significant positive correlation between GA, birth weight and coagulation factors II, VII, IX, X. In this study a highly significant negative association between coagulation factors II, VII, IX, X and PT, APTT was found. In our study mode of delivery and Maternal medication or antenatal exposure to corticosteroids did not affect the measured coagulation status. In this study no significant statistical impact of gender on coagulation factor II, IX, X% activity .While a statistically significant impact of gender on coagulation factor VII % activity was found. No statistically significant association was found between respiratory distress and coagulation factor II, VII, X. While statistically significant association between respiratory distress and coagulation factor IX was found. In this study there was a statistically significant decrease in the studied coagulation factors in died neonate. In conclusion, Levels of vit-k dependent coagulation proteins (II,VII ,IX ,X) are gestation-Dependent and inversely proportional to gestational age. Healthy infants exhibit low levels of vitamin K-dependent factors (II, VII, IX, and X) at birth, as well as prolonged (PT) and (APTT). Factor VII was the only factor affected by neonatal sex. While factor IX was the lowest one in neonate with respiratory distress. More studies on larger number of subjects are highly recommended for establishment of normative data of coagulation proteins especially factor VII &IX and to study fibrinolytic system in this age group. |