Hemostatic profile in healthy premature neonates; does birth weight affect the coagulation profile?

There are limited studies assessing the neonatal hemostatic factors in relation to birth weight.

This study aims to compare the coagulation factors between three groups of neonates with different birth weight for gestational age (GA).

In a cross-sectional study, 74 healthy premature neonates were involved.

Serum prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), thrombin clotting time (TT), and levels of fibrinogen, anti-thrombin III, protein S and protein C were measured. Neonates were classified into three groups according to birth weight, including small, appropriate and large for gestational age (SGA, AGA, and LGA).

Statistical analysis was performed using SPSS software.

There was a significant difference in the levels of protein S (P < 0.001), protein C (P = 0.004), and values of APTT (P = 0.01) between three groups. Other coagulation factors however, did not represent a significant pattern (P > 0.05). Protein S concentration, directly (B = 0.78, P < 0.001), and APTT, inversely (B = -0.29, P = 0.03), associated with birth weight after adjustment for GA and sex.

Despite the decrease in APTT from SGA to AGA, and LGA neonates, levels of protein S increases directly with birth weight. However, no other coagulation factors revealed an explainable pattern in relation to the state of SGA, AGA, or LGA.