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Role of thrombophilic factors in full-term infants with neonatal encephalopathy.
MedLine Citation:
PMID:  23128422     Owner:  NLM     Status:  Publisher    
BackgroundNeonatal encephalopathy (NE) is a serious condition, primarily seen following hypoxia-ischemia (HI). Two different patterns of brain injury can be recognised on MRI: white matter/watershed (WM/WS) or basal ganglia/thalamus (BGT) injury. Whether these patterns of injury can be attributed to different associated risk factors still needs to be established.MethodsIn 118 infants with clinical signs of NE following perinatal HI, thrombophilic factors were prospectively investigated. These included factor V Leiden and prothrombin gene mutation, C677T and A1298C polymorphisms in the MTHFR gene and plasma levels of homocysteine and lipoprotein(a). Antenatal and perinatal variables were studied.ResultsWM/WS injury was seen in 45 infants, BGT injury in 40 and normal neuro-imaging in 33 infants. Antenatal factors did not differ across these groups. The BGT pattern was associated with lower Apgar scores. WM/WS pattern was associated with hypoglycemia (<2.0 mmol/L), CT or TT 677 polymorphism in the MTHFR gene and plasma homocysteine levels in the upper quartile.ConclusionAcross three patterns of injury in infants with NE following perinatal HI, WM/WS pattern was associated with hypoglycemia, the MTHFR 677CT or TT genotype, and higher levels of plasma homocysteine. Basal ganglia/thalamus injury showed an association with signs suggestive of acute HI.Pediatric Research (2012); doi:10.1038/pr.2012.150.
Johanneke Harteman; Floris Groenendaal; Manon Benders; Albert Huisman; Henk Blom; Linda de Vries
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-05
Journal Detail:
Title:  Pediatric research     Volume:  -     ISSN:  1530-0447     ISO Abbreviation:  Pediatr. Res.     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-6     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0100714     Medline TA:  Pediatr Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
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