Abstract
Background: ROTEM assay has gained increasing acceptance as a method for rapid and specific coagulation pathway assessment. However, its use in the neonatal population remains limited since reference ranges have not yet been established. Aims: (1) to determine reference ranges for healthy term neonates of ROTEM parameters using non-activated assay (NATEM) in cord blood samples; (2) to assess whether delivery mode, gender, gestational age, birth weight and blood group (ABO and Rhesus) of the neonate, coagulation disorder and anticoagulant medication of the mother have an impact on NATEM parameters. Methods: NATEM assay was conducted in cord blood samples of 189 term neonates without any medical history. Results: Reference ranges (2.5th and 97.5th percentiles) are established for clotting time (CT), clot formation time (CFT), α-angle, clot amplitude at 5, 10 and 20 min (A5, A10, A20), maximum clot firmness (MCF), lysis index at 30 and 60 min (LI30, LI60, %) and maximum clot elasticity (MCE). Reference ranges for NATEM are CT 182–499 s, CFT 63–176 s, α-angle 58–78°, A5 28–52 mm, A10 37–61 mm, A20 42–66 mm, MCF 43–67 mm, LI30 97–100%, LI60 87–98% and MCE 75–203. Male neonates appear to be more hypocoagulable than females. Conclusions: We demonstrate reference ranges for healthy term neonates in NATEM assay that could be used as a reference group for future studies of neonates with an underlying pathology.
Highlights
Introduction published maps and institutional affilHemostasis in the neonatal period is an evolving process that starts in the intrauterine life and continues to undergo changes until adulthood
The primary aim of our study was to determine reference ranges for term neonates without any medical history of ROTEM parameters using non-activated assay (NATEM) in cord blood samples, which can be used in future studies
Term neonates without any medical history with gestational age (GA) ≥37 weeks and appropriate birth weight (BW) for GA born at Magginio Maternity Clinic, Aretaieio Hospital, National and Kapodistrian University of Athens, from March 2021 up to November 2021 comprised the study population
Summary
Hemostasis in the neonatal period is an evolving process that starts in the intrauterine life and continues to undergo changes until adulthood This age-related maturation is described by the term “developmental hemostasis”, first described by Maureen Andrews in the 1980’s and includes quantitative and qualitative differences in hemostatic factors [1,2,3,4,5]. Aims: (1) to determine reference ranges for healthy term neonates of ROTEM parameters using non-activated assay (NATEM) in cord blood samples; (2) to assess whether delivery mode, gender, gestational age, birth weight and blood group (ABO and Rhesus) of the neonate, coagulation disorder and anticoagulant medication of the mother have an impact on NATEM parameters. Reference ranges for NATEM are CT 182–499 s, CFT 63–176 s, α-angle 58–78◦ , A5 28–52 mm, A10 37–61 mm, A20 42–66 mm, MCF 43–67 mm, LI30
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