Impact of thrombophilia on the risk of hypoxic ischemic encephalopathy in term neoxnates

الملخص EN

BACKGROLINÜ The incidence of neonatai hypoxic-ischeinic encephalopatiiy (HIE) is reportediy high iii countries with limited resources.

Its patliogenesis is muitifactorial.

A role for thrombopiiiiia lias becn described in différent patterns of preterm and full terin périnatal brain injury.

AIM OF THE STIJDY; This study aimed to identify risk factors associated with neonatai HIE and also to determine the contributions of genetic thrombophilia in the development of neonatai HIE.

METHODS: Sixty-seven neonates with HIE and 67 Controls were enrolled in the study.

Clinical history and examination were undertaken, Patients and Controls were tested for presence of factor V I.eiden and prothrombin G20210A mutations.

In addition, protein S, protein C and antithrombin III levels were assessed.

RESULTS; Parental consanguinity and performing emergency cesarean section were significant risk factors for neonatai HIE (OR 6.5, 95% Cl 2.6 - 15.3, p < 0.001, OR 12.6, 95% CI 2.52 - 63,3, p = 0.002 respectively).

No significant ditTerencc was found regarding maternai âge and parity.

About 33% of cases and 6% of Controls were found to have at least one thrombophilic factor (p < 0.001).

Factor V i.eiden mutation significantly increased the risk of neonatai HIE (OR 4.5, 95% Cl 1.4 -14.5, p 0.012), w'hile prothrombin G 202 lOA mutation and protein C deficiency were not.

CONCLUSIONS: Parental consanguinity, emergency CS, any thrombophilic factor, particularly factor V mutation may contribute to the higher risk of developing neonatai HIE.