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Abstract Protein Z (PZ) is a single chain, vitamin K- dependent glycoprotein that was purified from human plasma in 1984 ,analogous with the majority of the coagulation proteins, protein Z is synthesized in the liver. It is 62 kDa large and 396 amino acids long. The PROZ gene has been linked to the thirteenth chromosome (13q34). The physiological function of protein Z is still rather ill defined. As is the case with other coagulation proteins and inhibitors, protein Z is consumed during disseminated intravascular coagulation (DIC) . It was found an association between low protein Z levels and first unexplained early fetal loss, Paidas and researcher found significantly lower first-trimester protein Z levels in a group of patients with complicated pregnancy outcomes such as bleeding, preeclampsia, preterm delivery, premature rupture of membranes and intrauterine growth restriction, as compared to women with normal pregnancy outcomes. In this study we described the incidence of protein Z deficiency in neonates with RDS, SGA and Infant of pre-eclampsic mother and there’s significant decrease in protein z levels in patient group than control group. This study was conducted on 85 neonate admitted to the pediatric Department of Menofia University neonatal intensive care unit from January 2013 to 30 July 2013. On the day of birth, all information on gestational age, based on last menstrual period and Dubovitz assessment, head circumference, weight, Apgar score at 1 and 5 min, clinical data and medications was recorded. Additional information was collected on maternal history, maternal diseases, medications and mode of delivery. Inclusion criteria:- Healthy term and preterm newborns normal for gestational age (NGA) and newborns belonging to one of the following groups: newborns small for gestational age (SGA); newborns affected by RDS, diagnosed on lung X-ray findings, together with the beginning of respiratory symptoms and the need for any type of ventilatory support; and newborns from mothers affected by pre-eclampsia. Exclusion criteria. Newborns with sepsis, congenital malformations or hemorrhagic disorders. Newborns were divided into the following groups : Group I, newborns affected by RDS 20 (10 males and10 females). Group II, newborns from mothers affected by pre-eclampsia 18 (10 males and 8 females). Group III, newborns small for gestational age (SGA) 17 (9 males and 8 females). (group IV) Healthy term and preterm neonate 30 (13 males and 17 females). Investigations:- Chest X-ray when indicted, Complete blood count (C.B.C), C-reactive protein (C.R.B) to exclude sepsis, Arterial blood gases (A.B.G) when 1ndicated, Prothrombin time , partial thromboplastin time (PT , PTT) and Protein Z by Immunoenzymatic method (ELISA). from this study :- There was no statistical significant difference between group I, II , III& IV as regard head circumference, post natal ag, andsex where p value was >0.05. ` There was statistical significant difference between group I , III& IV as regard weight where p value was <0.05.There was no statistical significant difference between group I, II , III& IV as regard maturity and mode of delivery where p value was >0.05. There was statistical significant difference between group I & IV as regard gestational age where p value was <0.05. There was statistical significant difference between group I, II , III& IV as regard apgar score where p value was <0.05. ` There was statistical significant difference between group I, II , III& IV as regard Protein Z: where p value was <0.05. ` There was no statistical significant difference between group II , III& IV as regard chest examination where p value was >0.05. ` In conclusion, in newborns affected by severe RDS, in newborns born to pre-eclamptic mothers and in SGA newborns there is a PZ deficiency which is probably related to activated coagulation in the first two conditions and to a reduced synthesis in the last one. |