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20 May 2004

Coagulation inhibitors – antithrombin and protein C and periventricular leukomalacia in premature infants

Piotr Korbal, Małgorzata Ćwiklińska-Jurkowska, Iwona Sadowska-Krawczenko, Wiesław Szymański

Med Sci Monit 2004; 10(2): 88-91 :: ID: 11852


Background: Despite the great progress in neonatology since the 1990s, brain injury and neurodevelopmental impairment in the newborns remain common. Cranial imaging and neuropathology data indicate that periventricular leukomalacia can coexist with periventricular-intraventricular haemorrhage but they also may have separate pathogenic mechanisms. PVL refers to necrosis of the periventricular matter adjacent to the external angles of the lateral ventricles. The pathogenesis of this lesion relates to three major interacting factors: an incomplete state of development of the vascular supply to the cerebral white matter, a maturation-dependent impairment in regulation of cerebral blood flow and the maturation-dependent vulnerability of the oligodendroglial (OL) precursor cell that represents the major cellular target in PVL. The purpose of our study was to evaluate possible correlation between coagulation inhibitors and periventricular leukomalacia. Material/Methods: Serum samples were tested from 189 premature infants 20–30 minutes after delivery and on the 3rd day of life. Following laboratory tests were performed: C- reactive protein (12 hours after delivery), blood gases, blood cell count with smear, antithrombin activity, protein C activity, electrolytes. Arterial blood pressure was also measured.Results: 19 of 189 newborns were diagnosed with PVL according to cranial ultrasonography and neurological examination performed at the age of 2 months. In the group of children with PVL we have found lower activity of antithrombin and protein C in comparison to children without PVL.Conclusions: Etiology of periventricular leukomalacia is multifactorial and we conclude that activation of coagulation may have a significant effect on the patophysiology of this complication.

Keywords: antithrombin, periventricular leukomalacia, Protein C

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750