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Coagulation parameters in the newborn and infant – the Copenhagen Baby Heart and COMPARE studies

  • Sofie Taageby Nielsen , Nina Strandkjær , Ida Juul Rasmussen , Malene Kongsgaard Hansen , Rikke Mohr Lytsen , Pia R. Kamstrup , Line Rode , Jens P. Goetze , Kasper Iversen , Henning Bundgaard and Ruth Frikke-Schmidt EMAIL logo
Published/Copyright: November 9, 2021
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 60 Issue 2

Abstract

Objectives

The coagulation system is not fully developed at birth and matures during the first months of infancy, complicating clinical decision making within hemostasis. This study evaluates coagulation parameters at birth and two months after birth, and tests whether cord blood can be used as a proxy for neonatal venous blood measurements.

Methods

The Copenhagen Baby Heart Study (CBHS) and the COMPARE study comprise 13,237 cord blood samples and 444 parallel neonatal venous blood samples, with a two month follow-up in 362 children.

Results

Because coagulation parameters differed according to gestational age (GA), all analyses were stratified by GA. For neonatal venous blood, reference intervals for activated partial thromboplastin time (APTT) and prothrombin time (PT) were 28–43 s and 33–61% for GA 37–39 and 24–38 s and 30–65% for GA 40–42. Reference intervals for international normalized ratio (INR) and thrombocyte count were 1.1–1.7 and 194–409 × 109/L for GA 37–39 and 1.2–1.8 and 188–433 × 109/L for GA 40–42. Correlation coefficients between umbilical cord and neonatal venous blood for APTT, PT, INR, and thrombocyte count were 0.68, 0.72, 0.69, and 0.77 respectively, and the distributions of the parameters did not differ between the two types of blood (all p-values>0.05).

Conclusions

This study describes new GA dependent reference intervals for common coagulation parameters in newborns and suggests that cord blood may serve as a proxy for neonatal venous blood for these traits. Such data will likely improve clinical decision making within hemostasis among newborn and infant children.

Keywords: coagulation; cord blood; hemostasis; neonatology; reference intervals
Corresponding author: Ruth Frikke-Schmidt, MD, DMSc, Professor, Chief Physician, Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen, Denmark; and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark, Phone: +45 3545 4348, Fax: +45 3545 2880, E-mail:

Funding source: The Research Council at Herlev-Gentofte Hospital

Funding source: The Danish Heart Foundation

Funding source: The Regions Research Foundation

Acknowledgments

We thank the staff at the maternity wards at Herlev Hospital, Hvidovre Hospital, and Rigshospitalet. We are grateful to the staff and participants of the Copenhagen Baby Heart Study and the COMPARE study for their important contributions to the cohorts.

  1. Research funding: This work was supported by the Research Council at Herlev-Gentofte Hospital, The Danish Heart Foundation, and The Regions Research Foundation. The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The research related to human use has complied with all the relevant national regulations, institutional policies, and in accordance with the tenets of the Helsinki Declaration (as revised in 2013), and has been approved by the authors’ Institutional Review Board, the Regional Ethics Committee of the Capital Region of Denmark (H-16001518), and the Danish Data Protection Agency (I-Suite no.: 04546, ID-no. HGH-2016-53).

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2021-0967).

Received: 2021-09-02
Accepted: 2021-10-25
Published Online: 2021-11-09
Published in Print: 2022-01-27

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2021-0967
Keywords for this article
coagulation; cord blood; hemostasis; neonatology; reference intervals

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The clinical value of assessing the inter-method bias: the lesson from prostate specific antigen measurement
  4. Mini Review
  5. Methods to reduce lipemic interference in clinical chemistry tests: a systematic review and recommendations
  6. Opinion Paper
  7. Troponin interference with special regard to macrocomplex formation
  8. Guidelines and Recommendations from Scientific Societies
  9. Use of high-sensitivity cardiac troponins in the emergency department for the early rule-in and rule-out of acute myocardial infarction without persistent ST-segment elevation (NSTEMI) in Italy
  10. Genetics and Molecular Diagnostics
  11. Effect of preexamination conditions in a centralized-testing model of non-invasive prenatal screening
  12. General Clinical Chemistry and Laboratory Medicine
  13. Comparative study of human growth hormone measurements: impact on clinical interpretation
  14. Establishing pre-analytical requirements and maximizing peptide recovery in the analytical phase for mass spectrometric quantification of amyloid-β peptides 1–42 and 1–40 in CSF
  15. Validation of the LUMIPULSE automated immunoassay for the measurement of core AD biomarkers in cerebrospinal fluid
  16. Targeted profiling of 24 sulfated and non-sulfated bile acids in urine using two-dimensional isotope dilution UHPLC-MS/MS
  17. High-resolution capillary electrophoresis for the determination of carbamylated albumin
  18. Real-time monitoring of drug laboratory test interactions: a proof of concept
  19. Afamin predicts the prevalence and incidence of nonalcoholic fatty liver disease
  20. Reference Values and Biological Variations
  21. Blood sampling frequency as a proxy for comorbidity indices when identifying patient samples for review of reference intervals
  22. Coagulation parameters in the newborn and infant – the Copenhagen Baby Heart and COMPARE studies
  23. Hematology and Coagulation
  24. Policies and practices in the field of laboratory hematology in Croatia – a current overview and call for improvement
  25. Cardiovascular Diseases
  26. Evaluation of the Atellica TnIH cardiac troponin I assay and assessment of biological equivalence
  27. Infectious Diseases
  28. Inadequate design of mutation detection panels prevents interpretation of variants of concern: results of an external quality assessment for SARS-CoV-2 variant detection
  29. Letters to the Editors
  30. The pronounced decline of anti-SARS-CoV-2 spike trimeric IgG and RBD IgG in baseline seronegative individuals six months after BNT162b2 vaccination is consistent with the need for vaccine boosters
  31. ACE polymorphism is a determinant for COVID-19 mortality in the post-vaccination era
  32. A look at the precision, sensitivity and specificity of SARS-CoV-2 RT-PCR assays through a dedicated external quality assessment round
  33. Value of hypocalcemia and thromboinflammatory biomarkers for prediction of COVID-19 severity during the second wave: were all the waves the same?
  34. Metagenomic next-generation sequencing (mNGS) confirmed a critical case of severe fever with thrombocytopenia syndrome virus (SFTSV)
  35. Biotin interference: evaluation of an updated thyroglobulin electrochemiluminescent immunoassay
  36. Evaluation of the Beckman Coulter Access Procalcitonin Assay: analytical and clinical performance
  37. Analytical performance evaluation of the new sST2 turbidimetric assay implemented in laboratory automation systems
  38. Pre-analytical recommendations and reference values for circulating calprotectin are sample type and assay dependent
  39. Congress Abstracts
  40. Annual Meeting of the Royal Belgian Society of Laboratory Medicine: “Women’s health: from puberty to menopause”
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