Kulkarni AA, Osmond M, Bapir M, et al. The effect of labour on the coagulation system in the term neonate. Haemophilia 2013; 19:533–538. doi: 10.1111/hae.12115

This study provides valuable information about the effect of labour on the coagulation system of the foetus.To assess the influence of maternal age, mode of delivery and intrapartum events, and foetal gender and weight on the foetal coagulation system, cord blood was collected from 154 healthy pregnant women, with gestational age 37 – 42 weeks at birth. Mann–Whitney test was used for analysis of binary data and continuous variables were analysed using Pearson's correlation coefficient. Mean cord blood levels of FVIII:C, VWF:Ag, VWF:CB, FIX, FXI, FXII and plasminogen were significantly higher in babies delivered after labour, compared to those delivered after an elective caesarean. Mean cord blood levels of FII (P = 0.003), FV (P = 0.009), FVII (P = 0.0004) and FX (P = 0.0009) were significantly lower in the babies with meconium stained liquor in labour, compared with those with clear liquor. No factor levels were affected by augmentation with oxytocin or instrumental delivery. Duration of labour also did not have an effect on the level of coagulation proteins in cord blood. The authors conclude that, in cord blood, consideration of the results of coagulation parameters in the newborn baby should occur in light of mode of delivery and labour events.

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