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The impact of intrauterine growth on coagulation and factor XII function in preterm infants

Şükran Yildirim1, Asuman Çoban2, Ayşegül Ünüvar3

  • 1Istanbul Prof. Dr Cemil Tascioglu City Hospital, Neonatal Intensive Care Unit, University of Health Sciences.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|April 28, 2025
PubMed

Insights

Intrauterine growth restriction (IUGR) significantly alters coagulation in preterm infants, particularly those born before 32 weeks. Lower levels of key clotting factors and higher factor XII suggest fresh frozen plasma may be beneficial for bleeding risks.

Area of Science:

  • Neonatal Medicine
  • Hematology
  • Perinatology

Background:

  • Intrauterine growth restriction (IUGR) is a significant concern in preterm neonates.
  • Coagulation disturbances are common in preterm infants, potentially exacerbated by IUGR.
  • Understanding these impacts is crucial for managing bleeding risks and treatment strategies.

Purpose of the Study:

  • To investigate the specific effects of IUGR on coagulation profiles in preterm newborns.
  • To evaluate the potential role of fresh frozen plasma administration in managing these infants.
  • To correlate coagulation changes with gestational age and the incidence of intraventricular hemorrhage.

Main Methods:

  • Comparative analysis of coagulation factors in 30 preterm infants with IUGR versus 32 without.
  • Blood sample analysis within 4 hours of birth, including coagulation factors, blood gases, and CBC.
  • Statistical assessment of differences between groups using SPSS version 15.

Main Results:

  • Preterm infants with IUGR, especially those born before 32 weeks, exhibited significantly lower levels of coagulation factors V, VII, XIII, and antithrombin III.
  • Elevated levels of factor VIII and prolonged thromboplastin times were observed in IUGR infants.
  • Factor XII levels were significantly higher in all preterm infants with IUGR, potentially linked to hypoxia and inflammation.

Conclusions:

  • IUGR profoundly impacts neonatal coagulation, with distinct alterations in specific clotting factors.
  • Conventional coagulation tests may not fully predict bleeding in IUGR preterm infants but aid in assessing intraventricular hemorrhage risk.
  • Fresh frozen plasma administration is a viable consideration for bleeding preterm infants with IUGR, particularly those born before 32 weeks.

Keywords:
coagulationfactor XIIintrauterine growth restrictionintraventricular hemorrhage

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