Apgar score and blood coagulation factors

Area of Science:

• Neonatal Medicine
• Hematology
• Pediatric Pathology

Background:

• Neonatal blood coagulation is complex and can be affected by perinatal factors.
• Apgar scores provide an initial assessment of newborn health status.
• Understanding coagulation in neonates is crucial for identifying at-risk infants.

Purpose of the Study:

• To investigate the relationship between Apgar scores and blood coagulation parameters in newborns.
• To identify potential markers of coagulation dysfunction in neonates with varying health statuses.
• To explore the incidence of consumption coagulopathy and disseminated intravascular coagulation (DIC) in relation to Apgar scores.

Main Methods:

• Blood coagulation tests were performed on 93 newborn infants at 0, 24, and 48 hours of life.
• Tests included bleeding time, clotting times, coagulation factor levels (I, V, VIII, X), platelet count, and clot lysis.
• Infants were grouped based on Apgar scores at 1 and 5 minutes.

Main Results:

• Significant differences in mean blood coagulation factor levels were observed immediately after birth among groups with different Apgar scores.
• These differences were primarily linked to the health status of neonates, with depressed infants showing more pronounced alterations.
• Ten infants who died exhibited clinical and laboratory findings consistent with disseminated intravascular coagulation (DIC), with two showing microthrombosis upon necroscopy.

Conclusions:

• Lower Apgar scores in newborns are associated with significant alterations in blood coagulation parameters.
• Neonates with depressed Apgar scores may experience activation of coagulation mechanisms, leading to consumption coagulopathy.
• Findings suggest a link between poor neonatal health, coagulation disturbances, and potentially fatal conditions like DIC.