Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy
Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-a...
Ausführliche Beschreibung
Autor*in: |
Deirdre Sweetman [verfasserIn] Lynne A. Kelly [verfasserIn] Zunera Zareen [verfasserIn] Beatrice Nolan [verfasserIn] John Murphy [verfasserIn] Geraldine Boylan [verfasserIn] Veronica Donoghue [verfasserIn] Eleanor J. Molloy [verfasserIn] |
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E-Artikel |
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Sprache: |
Englisch |
Erschienen: |
2019 |
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Übergeordnetes Werk: |
In: Frontiers in Pediatrics - Frontiers Media S.A., 2013, 7(2019) |
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Übergeordnetes Werk: |
volume:7 ; year:2019 |
Links: |
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DOI / URN: |
10.3389/fped.2019.00399 |
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Katalog-ID: |
DOAJ07301768X |
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520 | |a Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. | ||
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10.3389/fped.2019.00399 doi (DE-627)DOAJ07301768X (DE-599)DOAJ529e776eb80e47b28a7d2bb4accc590b DE-627 ger DE-627 rakwb eng RJ1-570 Deirdre Sweetman verfasserin aut Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. coagulopathy neonatal encephalopathy hypoxic-ischaemic encephalopathy EEG MRI Pediatrics Deirdre Sweetman verfasserin aut Deirdre Sweetman verfasserin aut Lynne A. Kelly verfasserin aut Zunera Zareen verfasserin aut Beatrice Nolan verfasserin aut Beatrice Nolan verfasserin aut John Murphy verfasserin aut John Murphy verfasserin aut Geraldine Boylan verfasserin aut Veronica Donoghue verfasserin aut Veronica Donoghue verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 7(2019) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:7 year:2019 https://doi.org/10.3389/fped.2019.00399 kostenfrei https://doaj.org/article/529e776eb80e47b28a7d2bb4accc590b kostenfrei https://www.frontiersin.org/article/10.3389/fped.2019.00399/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2019 |
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10.3389/fped.2019.00399 doi (DE-627)DOAJ07301768X (DE-599)DOAJ529e776eb80e47b28a7d2bb4accc590b DE-627 ger DE-627 rakwb eng RJ1-570 Deirdre Sweetman verfasserin aut Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. coagulopathy neonatal encephalopathy hypoxic-ischaemic encephalopathy EEG MRI Pediatrics Deirdre Sweetman verfasserin aut Deirdre Sweetman verfasserin aut Lynne A. Kelly verfasserin aut Zunera Zareen verfasserin aut Beatrice Nolan verfasserin aut Beatrice Nolan verfasserin aut John Murphy verfasserin aut John Murphy verfasserin aut Geraldine Boylan verfasserin aut Veronica Donoghue verfasserin aut Veronica Donoghue verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 7(2019) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:7 year:2019 https://doi.org/10.3389/fped.2019.00399 kostenfrei https://doaj.org/article/529e776eb80e47b28a7d2bb4accc590b kostenfrei https://www.frontiersin.org/article/10.3389/fped.2019.00399/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2019 |
allfields_unstemmed |
10.3389/fped.2019.00399 doi (DE-627)DOAJ07301768X (DE-599)DOAJ529e776eb80e47b28a7d2bb4accc590b DE-627 ger DE-627 rakwb eng RJ1-570 Deirdre Sweetman verfasserin aut Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. coagulopathy neonatal encephalopathy hypoxic-ischaemic encephalopathy EEG MRI Pediatrics Deirdre Sweetman verfasserin aut Deirdre Sweetman verfasserin aut Lynne A. Kelly verfasserin aut Zunera Zareen verfasserin aut Beatrice Nolan verfasserin aut Beatrice Nolan verfasserin aut John Murphy verfasserin aut John Murphy verfasserin aut Geraldine Boylan verfasserin aut Veronica Donoghue verfasserin aut Veronica Donoghue verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 7(2019) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:7 year:2019 https://doi.org/10.3389/fped.2019.00399 kostenfrei https://doaj.org/article/529e776eb80e47b28a7d2bb4accc590b kostenfrei https://www.frontiersin.org/article/10.3389/fped.2019.00399/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2019 |
allfieldsGer |
10.3389/fped.2019.00399 doi (DE-627)DOAJ07301768X (DE-599)DOAJ529e776eb80e47b28a7d2bb4accc590b DE-627 ger DE-627 rakwb eng RJ1-570 Deirdre Sweetman verfasserin aut Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. coagulopathy neonatal encephalopathy hypoxic-ischaemic encephalopathy EEG MRI Pediatrics Deirdre Sweetman verfasserin aut Deirdre Sweetman verfasserin aut Lynne A. Kelly verfasserin aut Zunera Zareen verfasserin aut Beatrice Nolan verfasserin aut Beatrice Nolan verfasserin aut John Murphy verfasserin aut John Murphy verfasserin aut Geraldine Boylan verfasserin aut Veronica Donoghue verfasserin aut Veronica Donoghue verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 7(2019) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:7 year:2019 https://doi.org/10.3389/fped.2019.00399 kostenfrei https://doaj.org/article/529e776eb80e47b28a7d2bb4accc590b kostenfrei https://www.frontiersin.org/article/10.3389/fped.2019.00399/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2019 |
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10.3389/fped.2019.00399 doi (DE-627)DOAJ07301768X (DE-599)DOAJ529e776eb80e47b28a7d2bb4accc590b DE-627 ger DE-627 rakwb eng RJ1-570 Deirdre Sweetman verfasserin aut Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy 2019 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. coagulopathy neonatal encephalopathy hypoxic-ischaemic encephalopathy EEG MRI Pediatrics Deirdre Sweetman verfasserin aut Deirdre Sweetman verfasserin aut Lynne A. Kelly verfasserin aut Zunera Zareen verfasserin aut Beatrice Nolan verfasserin aut Beatrice Nolan verfasserin aut John Murphy verfasserin aut John Murphy verfasserin aut Geraldine Boylan verfasserin aut Veronica Donoghue verfasserin aut Veronica Donoghue verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut Eleanor J. Molloy verfasserin aut In Frontiers in Pediatrics Frontiers Media S.A., 2013 7(2019) (DE-627)742738744 (DE-600)2711999-3 22962360 nnns volume:7 year:2019 https://doi.org/10.3389/fped.2019.00399 kostenfrei https://doaj.org/article/529e776eb80e47b28a7d2bb4accc590b kostenfrei https://www.frontiersin.org/article/10.3389/fped.2019.00399/full kostenfrei https://doaj.org/toc/2296-2360 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 7 2019 |
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coagulopathy neonatal encephalopathy hypoxic-ischaemic encephalopathy EEG MRI Pediatrics |
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Frontiers in Pediatrics |
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Deirdre Sweetman @@aut@@ Lynne A. Kelly @@aut@@ Zunera Zareen @@aut@@ Beatrice Nolan @@aut@@ John Murphy @@aut@@ Geraldine Boylan @@aut@@ Veronica Donoghue @@aut@@ Eleanor J. Molloy @@aut@@ |
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2019-01-01T00:00:00Z |
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Coagulation Profiles Are Associated With Early Clinical Outcomes in Neonatal Encephalopathy |
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Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. |
abstractGer |
Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. |
abstract_unstemmed |
Introduction: Neonatal encephalopathy (NE) is associated with coagulation abnormalities. We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality. |
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We aimed to investigate the serial alterations in coagulation profiles in term infants with NE and correlate with their clinical outcomes. This was a prospective cohort study in a tertiary referral, university-affiliated maternity hospital. Neonates exposed to perinatal asphyxia were recruited (n = 82) and 39 received therapeutic hypothermia. Infants had serial coagulation tests including platelets, prothrombin time (PT), activated partial thromboplastin time (aPTT) and fibrinogen in the first week of life. The main outcome measures included MRI brain and EEG seizures. Our results show that mortality was predicted on day 1 by decreased Fibrinogen (AUC = 0.95, p = 0.009) and by PT on day 2 with a cutoff of 22 s. An abnormal MRI was predicted by Fibrinogen on day 3 with a cut-off value of 2 g/L. For prediction of grade II/III NE, PT on day 2 of life was strongest with a cut-off value of 14 s. Only elevated APTT levels on day 1 of life were predictive of seizures (AUC = 0.65, p = 0.04).Conclusion: Coagulation parameters are strong predictors of outcomes such as abnormal NE grade, seizures, and mortality.</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">coagulopathy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">neonatal encephalopathy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">hypoxic-ischaemic encephalopathy</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">EEG</subfield></datafield><datafield tag="650" ind1=" " ind2="4"><subfield code="a">MRI</subfield></datafield><datafield tag="653" ind1=" " ind2="0"><subfield code="a">Pediatrics</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Deirdre Sweetman</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Deirdre Sweetman</subfield><subfield code="e">verfasserin</subfield><subfield code="4">aut</subfield></datafield><datafield tag="700" ind1="0" ind2=" "><subfield code="a">Lynne A. 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