| Objective The purpose is to investigate the common relative factors of coagulation disorder happened in hospitalized newborn (Secondary, Primary), finding the risk of coagulation test,to analysis the relationship between blood coagulation parameters and bleeding,to accurate judgment of neonatal coagulation conventional,to timely intervention of the occurrence of bleeding events,thus reducing the bleeding events and long-term sequelae by retrospective analysis of 625 cases of neonatal who had coagulation test.Methods1. Use retrospective analysis the clinical data of neonatal 625 cases who in admitted to Children’s Hospital of Chongqing Medical University in January 2014 and who had blood coagulation test.Analyze the relative factors in the newborn’s coagulation disorders,such as age, gestational-age, birth-weight, feeding-pattern, gender, the perinatal complications, diaeases.2. Used SPSS21.0 statistical software to analyze the data with Chi-square test, Fisher’s exact test, rank-sum test, rank correlation,P<0.05 with a statisitical significance.Results1. Of the 625 cases of hospitalized neonates,450 cases with blood coagulation disorder,175 cases were normal,the rate of blood coagulation was 72.00%.2. In the 450 cases of coagulation disorder,362 cases were the coagulation index APTT single prolonged (80.44%),88 cases were PT and APTT prolonged together (19.56%),no case only PT prolonged.3. In 450 cases of coagulation disorder,265 male cases and 185 female cases were reviewed, in 175 cases of normal,99 male cases and 76 female.The gender to the rate of coagulation disorder have no significant difference(P＞0.05).4. The age of 450 cases with coagulation disorder ranged from 1 hour to 653 hours, the median age was 55 hours,156 cases aged in 1 day,179 cases aged between 1 day to less than 7 days,115 cases aged more than 7 days. The age to the rate of coagulation disorder have significant difference(P<0.05).And the age more smaller,the more higher of the incidence of coagulation disorder.5. In 450 cases of coagulation disorder,19 cases’gestational age were less than 32 weeks,23 cases of the GA between 32 weeks and less than 34 weeks,91 cases of the GA between 34 weeks and less than 37 weeks, and 316 cases more than 37 weeks. The incidence of blood coagulation disorder decreased with increment of GA. The GA to the rate of coagulation disorder have significant difference(P<0.05),the smaller of the GA, the higher the incidence of coagulation disorder.6. The birth weight of 450 cases with coagulation disorder ranged from 1010g to 4900g,2994±690g on average, including 12 cases less than 1500g,94 cases between 1500g to less than 2500g,342 cases equal or more than 2500g,2 cases were unclear. the incidence of coagulation disorder’s with different BW respectively 100%,96.92%,66.79%,the lower of birth weight,the higher the incidence of coagulation disorder, there have significant difference (P<0.05).7. In the 450 cases with coagulation disorder,75 infants were exclusively breastfed,139 cases were formulafed,107 cases were mixed fed,129 cases no feeding. There were no significant differences in the rate of coagulation disorder among different groups divided by feeding pattern(P0.05), the no feeding groups has significant differences to each groups(P<0.05), the rate of coagulation disorder is more higher than others.8. There were 31cases with HDCP,27cases with ICP,29 cases with antenatal corticoateroids,36 cases were twins,70 cases with amniotic fluid dung dye,138cases with premature rupture of membranes,54cases with intrauterine distress,52cases with placental abnormality,59 cases with asphyxia, all of the above perinatal complications have significant differences to the incidence of coagulation disorder (P<0.05),the neonate with those perinatal complications the incidence of coagulation disorder increased significantly. But the lambing order,delivery method and umbilical cord around the neck have no significant differences(P>0.05)9. There were 16 cases with NRDS,42 cases with respiratory failure,52 cases with metabolic acidosis,77 cases with electrolyte disorder, 29 cases with sepsis,30 cases with crush injury,61 cases with hypoalbuminemia and 167 cases with liver function impairment, those disease have significant differences to the incidence of coagulation disorder (P<0.05),the neonate with those disease the incidence of coagulation disorder increased significantly. But the hyperbilirubinemia has no significant differences(P>0.05)10. In the 450 cases of newborn with blood coagulation disorder,178 cases have hemorrhagic manifestations; whereas there were 39 cases in the 175 cases of normal. the bleeding incidence of coagulation disorder was significant higher than the normal (P<0.05), moreover the bleeding is more severe.11. Follow-up the coagulation routine test of 100 cases who have coagulation disorder in the neonatal period, now the age is 1+year old,82 cases were normal (82.00%), and 18 cases (18.00%) is still abnormal, in the 18 cases (18.00%) of blood coagulation dysfunction, including 15 cases of single prolong APTT,1 case of PT,2 cases of PT and APTT prolong at the same time. In the 15 cases of single prolong APTT, 10cases were male,5 were female.Conclusions1. In the 625 cases of neonates,450 cases with blood coagulation disorder,175 cases were normal,the incidence of blood coagulation was 72.00%.2. In the 450 cases of coagulation disorder,362cases were single APTT prolonged(80.44%),88cases were PT and APTT prolonged at the same time(19.56%), APTT prolonged is more common.3. The coagulation function is significantly associated with GA、age、 BW, and the smaller of the GA and age,the lower of the BW, the higher incidence of the coagulation disorder.4. A variety of perinatal high-risk factor have an impact on coagulation function, the newborn with those factors need to be alert to coagulation disorder and the risk of bleeding.5. The neonate’ coagulation function was easily affected by disease, sick newborn need to be alert to the coagulation disorder and risk of bleeding.6. The incidence of bleeding is higher in the neonate who with coagulation disorder than the normal, and the bleeding is more severity, so the neonate with coagulation disorder should be alert to bleeding risk.7. Follow-up the coagulation routine test of 100 cases who have coagulation disorder in the neonatal period, now the age is 1+year old,18 cases (18.00%) is still abnormal, including 15 cases of single prolong APTT,1 case of PT,2 cases of PT and APTT prolong at the same time. In the 15 cases of single prolong APTT, 10cases were male,5 were female. The case which continuous coagulation disorder may need to be alert to congenital hemorrhagic disease, which should be follow-up coagulation routine test.8. In the 450 cases of coagulation disorder, follow-up 100 cases who take coagulation routine test,82cases were normal(82.00%), it’s indicates that most of the neonatal period blood coagulation disorder was the secondary causes of transient coagulation disorder. |
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