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Neonatal bleeding in haemophilia: a European cohort study
M Richards1, G Lavigne Lissalde, C Combescure
1Paediatric Haematology Department; Leeds General Infirmary, Leeds, UK. Michael.richards@leedsth.nhs.uk
British Journal of Haematology
|December 8, 2011
Summary
Assisted delivery significantly increases the risk of neonatal head bleeds in infants with haemophilia. Maternal awareness of haemophilia carrier status may offer protection against these bleeds.
Area of Science:
- Pediatrics
- Hematology
- Obstetrics
Background:
- Birth presents the initial hemostatic challenge for infants with hemophilia.
- Neonatal bleeding, particularly head bleeds, is a critical concern in these infants.
Purpose of the Study:
- To investigate the association between perinatal risk factors and major neonatal bleeding in infants diagnosed with hemophilia.
- To identify specific risk factors contributing to neonatal head bleeds in this population.
Main Methods:
- An observational cohort study involving 508 children with hemophilia A or B across 12 European treatment centers.
- Data collected from children born between 1990 and 2008.
- Univariate analysis was employed to assess risk factors for bleeding.
Main Results:
- Eighteen (3.5%) infants experienced head bleeds within the first 28 days of life, including cephalohaematomas and intracranial bleeds.
- Assisted delivery (forceps/vacuum) emerged as the sole significant risk factor for neonatal head bleeding (OR 8.84).
- Maternal awareness of hemophilia carrier status showed a protective trend against assisted delivery, though not statistically significant for bleeding events.
Conclusions:
- Assisted delivery is a primary risk factor for neonatal head bleeds in infants with hemophilia.
- While not statistically significant, maternal awareness of carrier status may offer a protective effect.
- Further research with larger cohorts may elucidate the protective role of maternal awareness and other factors.
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