Enhanced coagulation activation with reduced antithrombin III (ATIII) activity was seen in healthy neonates. Although systemic tissue plasminogen activator (t-PA) and urokinase-like plasminogen activator (u-PA) levels showed no significant differences from those of normal adults, enhanced fibrinolysis was indicated by elevated D-dimer and low plasminogen levels in the neonates in this study. Enhanced fibrinolysis was countered by elevated plasminogen activator inhibitor-1 (PAI-1) levels, a trend similar to that observed in the amniotic fluid during labour. The elevated PAI-1 level seen in neonates may have a beneficial effect in preventing haemorrhage in the neonatal period.
The haemostatic and fibrinolytic mechanisms studied in normal pregnancy neonates were similar to those in neonates born to gestational diabetes mellitus (GDM) mothers. Further studies need to include neonates with poor outcome and low Apgar scores to assess their haemostatic status.
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The author(s) declare there are no affiliations with or involvement in any organisation or entity with any financial interest in the subject matter or materials discussed in this manuscript.
