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Abstract：
BACKGROUND: Intrauterine growth restriction (IUGR) is associated with hemorrhagic and thrombotic complications during the perinatal period. Thrombocytopenia, platelet dysfunction, and prolonged standard coagulation tests are observed in this population. The aim of this study is to examine the hemostatic profile of IUGR neonates with the use of a non-activated assay (NATEM) in cord blood samples.
METHODS: During an 18 month period, a NATEM ROTEM assay was performed on cord blood samples of 101 IUGR neonates. A total of 189 appropriate for gestational age (AGA) neonates were used as a control group. The NATEM variables recorded include the following: clotting time (CT); clot formation time (CFT); clot amplitude at 5, 10, and 20 min (A5, A10, A20); α-angle (a°); maximum clot firmness (MCF); lysis index at 30 and 60 min (LI30, LI60); and maximum clot elasticity (MCE).
RESULTS: IUGR neonates demonstrate a hypocoagulable state, with lower A5, A10, A2, MCF, and MCE values when compared to AGA. Using multiple linear regression, we determined IUGR as an independent factor influencing all NATEM parameters (except CT and LI30) exhibiting a hypocoagulable and hypofibrinolytic profile. Platelet count was positively correlated with A5, A10, A20, MCF, alpha angle, and MCE, and negatively correlated with CFT.
CONCLUSIONS: IUGR neonates appear with lower clot strength and elasticity and prolonged clot kinetics, as illustrated by ROTEM variables.
METHODS: During an 18 month period, a NATEM ROTEM assay was performed on cord blood samples of 101 IUGR neonates. A total of 189 appropriate for gestational age (AGA) neonates were used as a control group. The NATEM variables recorded include the following: clotting time (CT); clot formation time (CFT); clot amplitude at 5, 10, and 20 min (A5, A10, A20); α-angle (a°); maximum clot firmness (MCF); lysis index at 30 and 60 min (LI30, LI60); and maximum clot elasticity (MCE).
RESULTS: IUGR neonates demonstrate a hypocoagulable state, with lower A5, A10, A2, MCF, and MCE values when compared to AGA. Using multiple linear regression, we determined IUGR as an independent factor influencing all NATEM parameters (except CT and LI30) exhibiting a hypocoagulable and hypofibrinolytic profile. Platelet count was positively correlated with A5, A10, A20, MCF, alpha angle, and MCE, and negatively correlated with CFT.
CONCLUSIONS: IUGR neonates appear with lower clot strength and elasticity and prolonged clot kinetics, as illustrated by ROTEM variables.
摘要：
背景：宫内生长受限（IUGR）与围产期出血性和血栓性并发症有关。血小板减少症，血小板功能障碍,在该人群中观察到长时间的标准凝血测试。这项研究的目的是通过在脐带血样本中使用非活化测定（NATEM）来检查IUGR新生儿的止血特征。
方法：在18个月期间，对101例IUGR新生儿的脐带血样本进行了NATEMROTEM分析。总共189例适合胎龄（AGA）的新生儿作为对照组。记录的NATEM变量包括：凝血时间（CT）；凝块形成时间（CFT）；5、10和20分钟的凝块幅度（A5，A10，A20）；α角（a°）；最大凝块硬度（MCF）；30和60分钟的裂解指数（LI30，LI60）；和最大凝块弹性（MCE）。
结果：IUGR新生儿显示低凝状态，较低的A5，A10，A2，MCF，与AGA相比时的MCE值。使用多元线性回归，我们确定IUGR是影响所有NATEM参数(CT和LI30除外)的独立因素,这些参数表现为低凝和低纤溶.血小板计数与A5、A10、A20、MCF、α角,MCE,与CFT呈负相关。
结论：IUGR新生儿出现较低的凝块强度和弹性以及延长的凝块动力学，如ROTEM变量所示。
方法：在18个月期间，对101例IUGR新生儿的脐带血样本进行了NATEMROTEM分析。总共189例适合胎龄（AGA）的新生儿作为对照组。记录的NATEM变量包括：凝血时间（CT）；凝块形成时间（CFT）；5、10和20分钟的凝块幅度（A5，A10，A20）；α角（a°）；最大凝块硬度（MCF）；30和60分钟的裂解指数（LI30，LI60）；和最大凝块弹性（MCE）。
结果：IUGR新生儿显示低凝状态，较低的A5，A10，A2，MCF，与AGA相比时的MCE值。使用多元线性回归，我们确定IUGR是影响所有NATEM参数(CT和LI30除外)的独立因素,这些参数表现为低凝和低纤溶.血小板计数与A5、A10、A20、MCF、α角,MCE,与CFT呈负相关。
结论：IUGR新生儿出现较低的凝块强度和弹性以及延长的凝块动力学，如ROTEM变量所示。
