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Circulating tissue factor, tissue factor pathway inhibitor and D-dimer in umbilical cord blood of normal term neonates and adult plasma

Tay SP, Cheong SK, Boo NY

Blood Coagul Fibrinolysis, 2003 Feb;14(2):125-9.
PMID: 12632021

The investigation of many hemostatic defects in newborns is restricted by the lack of normal reference values. The coagulation system of the neonate differs in many ways from that of the adult. The present study was designed to compare the concentrations of tissue factor (TF), tissue factor pathway inhibitor (TFPI) and D-dimer (DD) in the umbilical cord blood of healthy newborns and in adult plasma. TF antigen was quantified using an in-house enzyme-linked immunosorbent assay, whereas TFPI and DD levels were measured with commercial kits. The mean TF level in cord blood (mean standard deviation, 183.94 103.63 pg/ml) was significantly higher ( = 0.008) than that in adults (136.64 65.09 pg/ml). Cord blood exhibited enhanced fibrinolysis, as was reflected by a significantly higher level of DD (924.57 733.87 ng/ml, 0.001) than that in adults (45.57 17.21 ng/ml). Conversely, cord blood (30.88 10.16 ng/ml) demonstrated significantly lower ( 0.001) TFPI levels than that in adults (55.77 21.16 ng/ml). However, no significant differences of these three hemostatic markers were noted between both gender groups in newborns and adults. Our findings indicate that an active and dynamic state of hemostasis exists in cord blood, as the fluidity of cord blood remains preserved in the presence of birth injury.

Matched MeSH terms: Fibrin Fibrinogen Degradation Products/analysis*
Fulltext Elevated plasma tissue factor levels in neonates with umbilical arterial catheter-associated thrombosis

Tay SP, Cheong SK, Boo NY

Malays J Pathol, 2006 Jun;28(1):41-8.
PMID: 17694958 MyJurnal

Catheterization of the umbilical artery has been a useful aid in the management of sick neonates for the past few decades. However, it is associated with various complications. Reported studies strongly suggest a significant role of intravascular catheterization in the development of aortic thrombi. Increase in thrombosis of large vessels is believed to be related to mechanical injury in the catheterized vessels, which provide direct exposure of blood to tissue factor (TF), the primary cellular initiator of the extrinsic coagulation pathway. This study was conducted to determine the levels of plasma TF, tissue factor pathway inhibitor (TFPI) and D-dimer (DD) in infants with umbilical arterial catheter (UAC)-associated thrombosis. Quantification of TF was carried out using an in-house sandwich ELISA, whereas TFPI and DD levels were measured with commercial immunoassay kits. Infants with UAC inserted were found to have significantly higher levels of plasma TF (p < 0.001) than baseline levels. However, there were no significantly elevated levels of TFPI or DD. Infants with UAC-associated thrombosis demonstrated a greater increase of TF level (median: 414.5 pg/mL; range: -76.0, 6667.0) than infants without UAC-associated thrombosis (105.0 pg/mL; -976.0, 9480.0; p = 0.009) following UAC insertion. Our findings indicate that quantification and monitoring of TF levels could predict thrombus formation in infants with indwelling UAC. Following umbilical arterial catheterisation, infants with an approximately 3-fold rise in plasma TF levels were most at risk of developing abdominal aorta thrombosis as confirmed by real-time abdominal ultrasonography.

Matched MeSH terms: Fibrin Fibrinogen Degradation Products/analysis
Prevalence and Clinical Features of Pulmonary Embolism in Pregnancy and Puerperium in the Post-COVID-19 Era

Tan TL, Illa NEB, Ting SY, Chiew SC, Gan Y, Ong ZW, et al.

Matern Child Health J, 2025 Mar;29(3):428-437.
PMID: 40085386 DOI: 10.1007/s10995-025-04067-w

OBJECTIVE: Interest in pulmonary embolism (PE) has undergone a renaissance since the emergence of COVID-19 pandemic, but PE researches among pregnant mothers in this post-COVID-19 era remains scarce. This study was conducted to (a) determine PE prevalence rate among pregnant and post-partum women with suspected PE after the COVID 19 pandemic, (b) compare the clinical characteristics, laboratory findings and CT features between the PE and non-PE cohorts, and (c) validate the Pregnancy-Adapted Geneva (PAG) score in our population.
METHODS: This retrospective cross-sectional study involved the review of all maternal cases with suspected PE who underwent diagnostic CTPA in year 2022.
RESULTS: A total of 120 patients represented by 90 pregnant patients and 30 post-partum patients were included in the analysis. The prevalence rate of PE was 22.5% (27/120) and gestational diabetes mellitus prevalence rate was significantly higher (48.1% vs. 26.9%; p = 0.037) in PE cohort. Besides, the proportion of patients with moderately and extremely raised peak D-dimer levels were significantly higher among the PE cohort. In patients with PE, the position of the most proximal clot was identified as subsegmental (n = 6, 22.2%) and segmental (n = 21; 77.8%). The predicted PE risk based on PAG score demonstrated poor calibration with the observed PE risk across all three groups, namely low-risk group (2.3% vs. 15.4%), intermediate-risk group (11.6% vs. 26.3%) and high-risk groups (61.5% vs. 0.0%).
CONCLUSION: Overall, PE among pregnant and post-partum populations remain a convoluted disease without distinctive clinical features. There is a need for a prospectively validated PE risk scores to guide its clinical diagnostic pathway.

Matched MeSH terms: Fibrin Fibrinogen Degradation Products/analysis
Fulltext Serotype-specific host responses in rhesus macaques after primary dengue challenge

Hickey AC, Koster JA, Thalmann CM, Hardcastle K, Tio PH, Cardosa MJ, et al.

Am J Trop Med Hyg, 2013 Dec;89(6):1043-57.
PMID: 24062475 DOI: 10.4269/ajtmh.13-0145

Dengue virus (DENV) is considered to be the most important arthropod-borne viral disease and causes more than 100 million human infections annually. To further characterize primary DENV infection in vivo, rhesus macaques were infected with DENV-1, DENV-2, DENV-3, or DENV-4 and clinical parameters, as well as specificity and longevity of serologic responses, were assessed. Overt clinical symptoms were not present after infection. However, abnormalities in blood biochemical parameters consistent with heart, kidney, and liver damage were observed, and changes in plasma fibrinogen, D-dimers, and protein C indicated systemic activation of the blood coagulation pathway. Significant homotypic and heterotypic serum immunoglobulins were present in all animals, and IgG persisted for at least 390 days. Serum neutralizing antibody responses were highly serotype specific by day 120. However, some heterotypic neutralizing activity was noted in infected animals. Identification of serotype-specific host responses may help elucidate mechanisms that mediate severe DENV disease after reinfection.

Matched MeSH terms: Fibrin Fibrinogen Degradation Products/analysis