Abstract
Background
The correlation between procoagulant levels—factor VIII (FVIII), von Willebrand factor (vWF), and fibrinogen—and risk of thrombosis has been well documented in adult populations. We hypothesize that interaction of passively transferred isoagglutinins in premature neonates with a compromised immune system may trigger an immune response that can target the immature gastrointestinal tract. The objective of this study is to evaluate if there are procoagulant level differences in preterm newborns stratified by ABO blood group.
Methods
VWF, FVIII, and fibrinogen levels were analyzed in neonates ≤32 weeks and/or birthweight ≤1500 g over the first 6 weeks of life. Demographic, blood type, and transfusion data were collected.
Results
Elevations in vWF and FVIII were found to be statistically significant in the third week of life in non-O neonates vs. type O neonates. FVIII was also found to be significantly elevated in week 1. Transfused neonates also showed elevations between weeks 0 and 3.
Conclusion
There appears to be a time-dependent variation in procoagulant factor levels in preterm newborns. Although the clinical significance remains unclear, prothrombotic factors vWF and FVIII are significantly higher in non-O blood-type preterm neonates in the third week of life.
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Acknowledgements
We would like to acknowledge the generous support of the Sykora family—the main contributor to the Neonatal Research fund in our NICU. Additionally, the authors would like to acknowledge Paula Maia at Loyola University Chicago for her diligent work in performing the ELISAs.
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A.L.: Manuscript author, revisions, patient recruitment, data collection, and analysis. W.J.: Director of the lab where samples were processed. O.H.: Statistical analysis and manuscript editing. S.M. and S.L.: data gathering and recruitment. P.J.D.C. and L.A.G.: data analysis and manuscript revision. J.K.M.: principal investigator.
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Lai, A., Jeske, W., Habeeb, O. et al. ABO blood group and procoagulant factors: the hypercoagulation hypothesis ABO and Procoagulant Factors. Pediatr Res 86, 316–322 (2019). https://doi.org/10.1038/s41390-019-0445-1
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DOI: https://doi.org/10.1038/s41390-019-0445-1
