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Increased concentrations of D-dimers in newborn infants
I R Hudson1, B E Gibson, J Brownlie
1Royal Hospital for Sick Children, Yorkhill, Glasgow.
Insights
Neonatal D-dimer (fibrinogen degradation fragment) levels vary significantly. Most infants had levels higher than the adult normal range, necessitating cautious interpretation in newborns.
Area of Science:
- Biochemistry
- Neonatal Medicine
- Hematology
Background:
- D-dimer levels reflect fibrinolysis, a process crucial for hemostasis.
- Establishing reference ranges for D-dimer in neonates is essential for accurate clinical interpretation.
- Existing adult D-dimer ranges may not be directly applicable to the neonatal population.
Purpose of the Study:
- To determine the normal range of D-dimer concentrations in preterm and full-term infants.
- To compare neonatal D-dimer levels with established adult ranges.
Main Methods:
- Blood samples were collected from 15 preterm and 45 full-term infants.
- D-dimer concentrations were measured using a validated assay.
- Data were analyzed to establish frequency distributions and ranges.
Main Results:
- 52% of the 60 infants studied had D-dimer concentrations below 0.25 mg/l.
- 27% of infants had levels between 0.25-0.5 mg/l, and 13% had levels between 0.5-1 mg/l.
- A small percentage of infants exhibited D-dimer levels exceeding 1 mg/l, with two infants having levels between 2-4 mg/l.
Conclusions:
- Neonatal D-dimer concentrations show considerable variability.
- A significant proportion of healthy neonates have D-dimer levels that differ from adult reference ranges.
- D-dimer measurements in the neonatal period require careful interpretation due to these variations.
Abstract:
The concentrations of D-dimers (the D fragments of fibrinogen) were measured in blood from 15 preterm infants, and 45 born at full term, to establish normal ranges. The adult normal range is less than 0.25 mg/l; 31 of the 60 infants (52%) had values less than 0.25 mg/l, in 16 (27%) they were 0.25-0.5, in eight (13%) 0.5-1, in three (5%) 1-2, and in two (3%) 2-4. D-dimer concentrations measured during the neonatal period should be interpreted with caution.