Heparin cofactor II, antithrombin and protein C in plasma from term and preterm infants

Area of Science:

• Pediatric Hematology
• Hemostasis and Thrombosis
• Neonatal Medicine

Background:

• Coagulation inhibitors like heparin cofactor II (HC II), antithrombin (AT), and protein C (PC) are crucial for hemostasis.
• Establishing reference ranges for these inhibitors in infants is essential for diagnosing deficiencies and monitoring health.
• Infant coagulation profiles differ significantly from adults, necessitating specific pediatric reference standards.

Purpose of the Study:

• To establish reference standards for HC II, AT, and PC in healthy term and preterm infants.
• To compare inhibitor levels between term and preterm infants.
• To investigate the clinical utility of HC II and AT measurements in neonates.

Main Methods:

• Measurement of HC II, AT, and PC levels in blood samples from healthy term and preterm infants.
• Comparison of infant values with adult reference ranges.
• Analysis of inhibitor levels in a cohort of unhealthy neonates.

Main Results:

• Mean HC II levels in term infants were approximately 50% of adult values.
• Significantly lower HC II and AT levels were observed in preterm infants compared to term infants.
• One case of congenital HC II deficiency was identified; low HC II levels (<25%) may indicate hereditary deficiency.
• In unhealthy neonates, HC II was reduced more than AT and normalized faster upon recovery.

Conclusions:

• Established reference standards for HC II, AT, and PC in infants.
• Preterm infants exhibit lower levels of HC II and AT than term infants.
• HC II deficiency screening is valuable in infants, and HC II dynamics may offer prognostic insights in critically ill neonates.