Abstract
Purpose
We analyzed coagulation and fibrinolysis markers at birth to identify predictors of the onset of necrotizing enterocolitis (NEC) in extremely low-birth-weight infants (ELBWIs).
Methods
We reviewed the medical records of ELBWIs born at our institution between 2013 and 2022. Patient background and blood test results at birth were compared between the NEC and control groups.
Results
Two hundred forty-six ELBWIs were enrolled in this study (control group, n = 226; NEC group, n = 20). The background characteristics were significantly difference between the two groups. The following coagulation and fibrinolysis markers at birth were compared between the control and NEC groups: prothrombin time (%), 62.2 ± 19.4 vs. 54.2 ± 24.4, p = 0.169; prothrombin ratio, 1.65 ± 0.55 vs. 1.39 ± 0.27, p = 0.052; activated partial thromboplastin time (min), 78.5 ± 31.1 vs. 95.6 ± 40.6, p = 0.083; fibrinogen (mg/dL), 160.7 ± 124.2 vs. 107.3 ± 67.1, p = 0.004; antithrombin III (%), 29.1 ± 7.8 vs. 28.4 ± 9.9, p = 0.083; D-dimer (µg/mL), 3.2 ± 2.5 vs. 11.7 ± 13.9, p = 0.013; soluble fibrin (µg/mL), 30.0 ± 26.9 vs. 35.7 ± 25.4, p = 0.372; thrombin antithrombin III complex (ng/mL), 9.0 ± 7.9 vs. 20.5 ± 28.1, p = 0.082; plasmin-α2 plasmin inhibitor complex (µg/mL), 1.04 ± 0.67 vs. 1.88 ± 3.0, p = 0.254; plasminogen activator inhibitor-1 (ng/mL), 23.0 ± 14.3 vs. 42.5 ± 59.5, p = 0.160; and factor XIII (%), 25.7 ± 8.2 vs. 24.7 ± 9.7; p = 0.667.
Conclusions
Low fibrinogen and high D-dimer levels at birth are potential predictors of the onset of NEC in ELBWIs.