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. 2022 Aug 1;6(5):e12751.
doi: 10.1002/rth2.12751. eCollection 2022 Jul.

Reduced platelet function in preterm neonates compared with term neonates

Nadia Thrane Hovgesen  1 , Claus V B Hviid  1 , Alexander K Grevsen  1 , Anne Kirkeby Hansen  2 , Anne-Mette Hvas  1   3
Affiliations

Reduced platelet function in preterm neonates compared with term neonates

Nadia Thrane Hovgesen et al. Res Pract Thromb Haemost. .

Abstract

Background: A reduced platelet function might contribute to the longer bleeding time seen in preterm neonates. However, the previously used platelet function testing in neonates is limited due to methodological limitations, mainly caused by difficulties in obtaining adequate blood volume. Therefore, the platelet function in preterm neonates is sparsely investigated. The aim of this study was to compare platelet function in preterm neonates at birth and at expected term age with platelet function in term neonates at birth.

Methods: We included 43 preterm neonates born at gestational age (GA) 28 + 0 to 34 + 0 and 21 term neonates born at GA 38 + 0 to 41 + 0. Within the first 24 hours of life, 1-1.5 mL peripheral blood was obtained and for preterm neonates, resampling was performed at expected term age (GA 38 + 0 to 41 + 0). Platelet function testing included impedance aggregometry and platelet activation measured by flow cytometry. In addition, platelet count was determined.

Results: Platelet count and platelet activation were reduced in preterm neonates compared with term neonates at birth, but we found no difference in impedance aggregometry at birth. At expected term age, platelet count and aggregation exceeded term levels, but platelet activation remained impaired in the preterm.

Conclusion: Preterm neonatal function is decreased at birth and does not seem to reach term levels during the first 4 to 13 weeks of life.

Keywords: flow cytometry; infant, premature; platelet activation; platelet count; platelet function tests.

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Figures

FIGURE 1
FIGURE 1
Platelet count in 39 preterm at birth, 28 preterm at expected term age, and 21 term neonates at birth. Please, note that birth versus expected term is paired data and the remaining is unpaired data. Note: The bars indicate median and interquartile range
FIGURE 2
FIGURE 2
Platelet impedance aggregometry in 41 preterm at birth, 28 preterm at expected term age, and 21 term neonates at birth. Please note that birth versus expected term is paired data and the remaining is unpaired data. Note: The bars indicate median and interquartile range. ADP, adenosine diphosphate; TRAP, thrombin receptor activating peptide‐6
FIGURE 3
FIGURE 3
Expression of platelet surface glycoprotein receptors as (A) percentage of positive platelets and (B) platelet median fluorescence intensity in 41 preterm at birth, 30 preterm at expected term age, and 21 term neonates at birth. Note: The bars indicate median and interquartile range. Bonferroni corrected significance level: P = .003. Please note that birth versus expected term is paired data and the remaining is unpaired data. GP, glycoprotein; MFI, median fluorescence intensity
FIGURE 4
FIGURE 4
Percentage of platelets expressing activation‐dependent surface markers–bound fibrinogen, CD63, and P‐selectin when activated by agonists collagen‐related peptide, adenosine diphosphate, thrombin receptor‐activating peptide 6 and arachidonic acid in 43 preterm at birth, 30 preterm at expected term age, and 21 term neonates at birth. Note: ARA missing in 1 term and 2 preterm. ADP missing in 1 preterm. The bars indicate median and interquartile range. Bonferroni corrected significance level: P = .004. Please note that birth versus expected term is paired data, and the remaining is unpaired data. ADP, adenosine diphosphate; ARA, arachidonic acid; CRP, collagen‐related peptide; TRAP, thrombin receptor‐activating peptide 6
FIGURE 5
FIGURE 5
Platelet MFI for activation‐dependent surface markers bound‐fibrinogen, CD63 and P‐selectin when activated by agonists collagen‐related peptide, adenosine diphosphate, thrombin receptor‐activating peptide 6 and arachidonic acid in 43 preterm at birth, 30 preterm at expected term age and 21 term neonates at birth. Note: ARA missing in 1 term and 2 preterm. ADP missing in 1 preterm. The bars indicate median and interquartile range. Bonferroni corrected significance level: p = 0.004. Please, note that birth vs expected term is paired data and the remaining is unpaired data. Abbreviations: ADP, adenosine diphosphate; ARA, arachidonic acid; CRP, collagen‐related peptide; MFI, median fluorescence intensity; TRAP, thrombin receptor‐activating peptide 6
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