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Published on: October 19, 2013
Protein C activity in severely ill newborns with congenital heart disease
P D Macdonald1, B E Gibson, J Brownlie
1Department of Cardiology, Royal Hospital for Sick Children, Glasgow, U.K.
Insights
Congenital heart disease in newborns is linked to low protein C activity, increasing risks for thrombosis and coagulation issues. Early detection of low protein C may aid in managing these severe neonatal conditions.
Area of Science:
- Neonatal Medicine
- Hematology
- Pediatric Cardiology
Background:
- Congenital heart disease (CHD) is a significant concern in neonates.
- Protein C deficiency can predispose individuals to thrombotic events.
Purpose of the Study:
- To investigate protein C functional activity levels in infants with symptomatic congenital heart disease.
- To assess the association between low protein C levels and thrombotic complications or coagulation factor consumption in this population.
Main Methods:
- Studied protein C functional activity in twenty-nine full-term infants with symptomatic CHD.
- Measured protein C levels on admission, comparing them to normal neonatal ranges.
- Monitored for thrombotic complications and evidence of coagulation factor consumption.
Main Results:
- Protein C levels varied widely, with a mean of 37.7%.
- Eight infants exhibited protein C levels significantly below the normal neonatal mean.
- Infants with low protein C showed increased incidence of thrombotic complications (2/8) and coagulation factor consumption (4/8).
- Critically ill infants were more prevalent in the low protein C group.
Conclusions:
- Severely ill newborns with congenital heart disease and protein C levels at or below the lower limit of normal are at heightened risk.
- These infants may face increased susceptibility to consumptive coagulopathy or major thrombosis.
- Monitoring protein C activity could be crucial for risk stratification in neonates with CHD.
Abstract:
Levels of protein C functional activity were studied in twenty-nine full-term infants with symptomatic congenital heart disease, who presented in the neonatal period. Protein C levels on admission ranged from < 10% to 61% (mean 37.7% S. D. 14.1%). Eight of the twenty-nine babies had protein C levels between 1.5 and > 3.0 S. D. below the normal neonatal mean with no parental evidence of familial deficiency. Of these infants with low protein C two developed thrombotic complications and four had evidence of coagulation factor consumption. Critically ill infants were over-represented in the group with low protein C. Severely ill newborn infants with protein C at or below the lower limit of the normal neonatal range may be at increased risk of either a consumptive coagulopathy or major thrombosis.
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