EFFECT OF DELIVERY MODALITIES ON the physiologic
inhibition system of coagulation in THE NEONATE.
Zanardo
V1, Franzoi M1, Savio V1, Simioni P2
1 Department of Pediatrics, Padua, Italy
2 Department of Medical and Surgical
Sciences, Padua, Italy
Objective: the stress associated with delivery may contribute to the
maturation of the coagulation system. The aim of this study was to evaluate
the influence of modality of delivery, spontaneous vaginal delivery or
elective caesarean section, on the neonatal physiologic inhibition system
of coagulation (PISC) factors, protein C, protein S and antithrombin III.
Methods: we studied 41 consecutive healthy newborns, 18 born after vaginal
delivery (GA 39.7 �� 0.8) and 23 after elective cesarean section (GA 38.5 ��
0.7). The samples were collected in sodium citrate 1:9 from umbilical cord
at birth, centrifuged and stored at -70�� C until measurement. We tested
ATIII activity, protein C antigen and activity (by chromogenic and
coagulometric method), total amount and free form protein S antigen, and
protein S activity.
Results: among PISC factors studied in cord blood of infants born after
vaginal delivery, antigen protein C and antithrombin III were statistically
higher (41,3 ��
9,4 vs 33,9 ��
7,2 % and 58,5 ��
10,0 vs 48,4 ��
12,7 %, respectively; p<.01 ), while free protein S was significantly
lower (36,8 ��
11,6 vs 46,4 ��
12,5 %; p<.05) than newborns by cesarean section.
Conclusion: our data show that labor stress of vaginal delivery influences some
PISC factors in cord blood. In newborns with coagulative disorders it is
reasonable to consider different ranges in coagulative screening tests,
related to delivery modality.