Clinical Research Article | Published:

Impaired platelet activity and hypercoagulation in healthy term and moderately preterm newborns during the early neonatal period

Abstract

Background

Preterm newborns are at thrombohemorrhagic risk during the early neonatal period. Taking into account the lack of informative tools for the laboratory diagnosis of hemostasis disorders in newborns, our goal was to determine the baseline values of thrombodynamics and platelet functional activity in healthy term and moderately preterm newborns during the early neonatal period future potential clinical use of these tests.

Methods

Coagulation was assessed using an integral assay of thrombodynamics and standard coagulation assays, and platelet functional activity was estimated by flow cytometry.

Results

Hypercoagulation of newborns, represented by a significantly higher clot growth velocity and the presence of spontaneous clots in the thrombodynamics, was combined with platelet hypoactivity. Granule release, phosphatidylserine exposure, and the ability to change shape upon activation were decreased in the platelets of moderately preterm newborns. The platelet function remained at the same level over the first four days of life, whereas the hypercoagulation became less pronounced.

Conclusions

The hemostasis of newborns is characterized by hypercoagulation combined with reduced platelet functional activity. Moderately preterm and term newborns do not differ in the parameters of coagulation, while some of the functional responses of platelets are lower in moderately preterm newborns than in term.

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Acknowledgements

Funding

This work was supported by a grant from the Russian Science Foundation (17-74-10224) to A.N.B.

Author information

E.M.K., E.N.B., M.A.P., and A.N.B. designed the study. E.N.B., O.V.I., A.R.K., A.A.L., L.A.T., V.V.Z., and D.N.D. recruited the participants and collected the clinical data from the participants. E.M.K. and A.D.K. performed the thrombodynamics assay, A.A.I. and D.M.P performed the platelet functional testing, and A.V.P. performed the other coagulation assays. E.M.K. performed the statistical analysis. E.M.K. wrote the manuscript, which was critically revised by A.N.B., E.N.B., and M.A.P. and finally approved by G.T.S. and F.I.A.

Competing interests

F.I.A. is former employee and founder of HemaCore LLC, which holds several patents and patent applications that are related to the diagnostic use of spatial clot growth and has developed an assay under the trade name of Thrombodynamics®.

Correspondence to Ekaterina M. Koltsova.

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