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  • Basic Science Article
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Comparison of standard and global hemostasis assays in cord and peripheral blood of newborns

Pediatric Research volume 97, pages 1732–1741 (2025)Cite this article

Abstract

Background

Umbilical cord blood is used for the testing of various parameters in newborns. However, data on its applicability for hemostasis assays is insufficient.

Objective

To evaluate whether umbilical cord blood can be used for standard tests, thromboelastometry and thrombodynamics for preterm and term newborns.

Methods

187 newborns were included in the study. Blood was taken from the umbilical cord and by venipuncture of the newborn. Clotting times, fibrinogen, D-dimer, thromboelastometry and thrombodynamics were measured.

Results

Clotting times and fibrinogen indicated a hypocoagulable shift, while thromboelastometry and thrombodynamics showed a hypercoagulable shift in hemostasis in umbilical cord blood compared to newborn blood. D-dimer indicated an enhanced process of thrombus lysis in newborn blood compared to cord blood. Collecting blood into a tube with the addition of a contact pathway inhibitor did not significantly change the global assay parameters in either umbilical cord blood or newborn blood. In the thrombodynamics assay, spontaneous clotting was detected but suppressed by the addition of a tissue factor inhibitor.

Conclusions

Hemostasis in cord and newborn blood differs for both global and standard tests. Hypercoagulability in newborns registered with the global assay thrombodynamics is associated with the presence of tissue factor in the blood.

Impact statement

  1. 1.

    We found a hypercoagulation shift in newborns compared with the adult references, possibly due to the presence of tissue factor in blood.

  2. 2.

    Blood coagulation is enhanced in cord blood compared with blood sampled from the vein of a newborn according to thromboelastometry and thrombodynamics assays.

  3. 3.

    Clotting times and fibrinogen concentrations in cord blood differ from these parameters in newborn blood.

  4. 4.

    Studying of the (patho)physiological features of hemostasis in newborns should consider differences in cord blood and vein sampled blood.

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Fig. 1: Study flowchart.
Fig. 2: Standard and global coagulation assays in the cord and peripheral blood of newborns.
Fig. 3: Standard and global coagulation assays in the cord and peripheral blood of newborns were performed with/without the addition of CTI to the blood collection tube.
Fig. 4: Effect of TF and FIXa inhibition on spontaneous clotting in the thrombodynamics assay.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

Russian Science Foundation, grant number 22-15-00164.

Author information

Authors and Affiliations

  1. National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician Kulakov V.I., Moscow, 117997, Russia

    Belinda V. Arutunyan, Margarita A. Shpilyuk, Leila A. Timofeeva, Anna L. Karavaeva, Ekaterina N. Balashova, Liubov V. Krechetova, Viktor V. Zubkov, Dmitry N. Degtyarev, Gennady T. Sukhikh & Nana K. Tetruashvili

  2. Center for Theoretical Problems of Physicochemical Pharmacology RAS, Moscow, 109029, Russia

    Ekaterina M. Koltsova, Elena N. Lipets, Fazoil I. Ataullakhanov & Anna N. Balandina

  3. Center of Pediatric Hematology, Oncology and Immunology, Moscow, 117198, Russia

    Ekaterina M. Koltsova, Fazoil I. Ataullakhanov & Anna N. Balandina

Authors
  1. Belinda V. Arutunyan
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  2. Ekaterina M. Koltsova
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  3. Margarita A. Shpilyuk
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  4. Elena N. Lipets
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  7. Ekaterina N. Balashova
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  9. Fazoil I. Ataullakhanov
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  13. Nana K. Tetruashvili
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  14. Anna N. Balandina
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Contributions

Conceptualization, A.N.B. and N.K.T.; methodology, E.M.K.; formal analysis, E.M.K. and A.N.B.; investigation, E.M.K., B.V.A., M.A.S., E.N.L, L.A.T., A.L.K., E.N.B.; data curation, B.V.A., M.A.S.; writing – original draft preparation, E.M.K., A.N.B.; writing – review and editing, N.K.T., E.N.B, M.A.S. and L.V.K.; visualization, A.N.B. and E.M.K.; supervision, F.I.A., V.V.Z., D.N.D and G.T.S; project administration, B.V.A.; funding acquisition, A.N.B. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Anna N. Balandina.

Ethics declarations

Competing interests

FIA is a former employee and cofounder of Hemacore, LLC. Hemacore LLC holds several patents and patent applications related to the diagnostic use of spatial clot growth and has developed the assay under the trade name Thrombodynamics®. Hemacore LLC did not have any additional role in the design of the study, collection and analysis of the data, or the decision to publish or prepare the manuscript. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results. All other authors declare no competing financial interests.

Ethics approval

The study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of the National Medical Research Center for Obstetrics, Gynecology and Perinatology named after academician Kulakov V.I. (Protocol code: 10, date of approval: 23 November 2017).

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Written informed consent was obtained from the legal representatives (parents) of the newborns to publish this paper.

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Arutunyan, B.V., Koltsova, E.M., Shpilyuk, M.A. et al. Comparison of standard and global hemostasis assays in cord and peripheral blood of newborns. Pediatr Res 97, 1732–1741 (2025). https://doi.org/10.1038/s41390-024-03475-y

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