Potential predictors of the onset of focal intestinal perforation in extremely low birth weight infants based on an analysis of coagulation and fibrinolysis markers at birth: A case-control study based on ten years of experience at a single institution

Abstract Purpose : We aimed to investigate potential predictors of focal intestinal perforation (FIP) in extremely low birth weight infants (ELBWIs) among coagulation and fibrinolysis markers at birth. Methods : We reviewed the medical records of FIP patients and their coagulation and fibrinolysis markers at birth between 2010 and 2019, and matched patients according to gestational age. FIP was diagnosed based on macroscopic intestinal perforation with a punched-out lesion without necrosis. Patient characteristics and blood test results, including coagulation and fibrinolysis marker levels, were compared between the groups. Results : Two hundred forty ELBWIs were enrolled in this study (FIP, n=18; controls, n=222). In the FIP group, the gestational age at birth was significantly younger (p=0.023) and the birth weight was significantly lower (p=0.007) in comparison to the control group. Furthermore, the FIP group showed significantly lower levels of fibrinogen (p=0.027) and factor XIII (F-XIII) (p=0.007). The receiver operating characteristics curves for fibrinogen and F-XIII revealed that the 95% confidence intervals of fibrinogen and F-XIII were 0.530-0.783 (p=0.027), and 0.574-0.822 (p=0.007), respectively. Conclusions : This is the first report focusing on coagulation and fibrinolysis markers in FIP patients at birth. The fibrinogen and F-XIII values at birth are potential predictors of FIP in ELBWIs. Type of Study : Study of Diagnostic Test (Case Control Study) Level of Evidence : Level IV