TY - JOUR
T1 - Neonatal bleeding in haemophilia: a European cohort study
AU - Richards, M.
AU - Lavigne Lissalde, G.
AU - Combescure, C.
AU - Batorova, A.
AU - Dolan, G.
AU - Fischer, K.
AU - Klamroth, R.
AU - Lambert, T.
AU - Lopez-Fernandez, M.
AU - Pérez, R.
AU - Rocino, A.
AU - Fijnvandraat, K.
PY - 2012
Y1 - 2012
N2 - Birth is the first haemostatic challenge for a child with haemophilia. Our aim was to examine the association between perinatal risk factors and major neonatal bleeding in infants with haemophilia. This observational cohort study in 12 European haemophilia treatment centres (HTC) incorporated 508 children with haemophilia A or B, born between 1990 and 2008. Risk factors for bleeding were analysed by univariate analysis. Head bleeds occurred in 18 (3.5%) children within the first 28 d of life, including three intraparenchymal bleeds, one subdural haematoma and 14 cephalohaematomas. Intra-cranial bleeds were associated with long-term neurological sequelae in two (0.4%) cases; no deaths occurred. Assisted delivery (forceps/vacuum) was the only risk factor for neonatal head bleeding [Odds Ratio (OR) 8.84: 95% confidence interval (CI) 3.0525.61]. Mild haemophilia and maternal awareness of her haemophilia carrier status seemed to be protective (OR 0.24; 95%CI 0.051.05 and OR 0.34; 95%CI 0.101.21, respectively), but due to the low number of events this was not statistically significant. We found no association between neonatal head bleeding and country, maternal age, parity, gestational age or presence of HTC. Maternal awareness of carrier status protected against assisted delivery (unadjusted OR 0.37; 95%CI 0.150.90; adjusted OR 0.47 (95%CI 0.181.21)
AB - Birth is the first haemostatic challenge for a child with haemophilia. Our aim was to examine the association between perinatal risk factors and major neonatal bleeding in infants with haemophilia. This observational cohort study in 12 European haemophilia treatment centres (HTC) incorporated 508 children with haemophilia A or B, born between 1990 and 2008. Risk factors for bleeding were analysed by univariate analysis. Head bleeds occurred in 18 (3.5%) children within the first 28 d of life, including three intraparenchymal bleeds, one subdural haematoma and 14 cephalohaematomas. Intra-cranial bleeds were associated with long-term neurological sequelae in two (0.4%) cases; no deaths occurred. Assisted delivery (forceps/vacuum) was the only risk factor for neonatal head bleeding [Odds Ratio (OR) 8.84: 95% confidence interval (CI) 3.0525.61]. Mild haemophilia and maternal awareness of her haemophilia carrier status seemed to be protective (OR 0.24; 95%CI 0.051.05 and OR 0.34; 95%CI 0.101.21, respectively), but due to the low number of events this was not statistically significant. We found no association between neonatal head bleeding and country, maternal age, parity, gestational age or presence of HTC. Maternal awareness of carrier status protected against assisted delivery (unadjusted OR 0.37; 95%CI 0.150.90; adjusted OR 0.47 (95%CI 0.181.21)
U2 - https://doi.org/10.1111/j.1365-2141.2011.08967.x
DO - https://doi.org/10.1111/j.1365-2141.2011.08967.x
M3 - Article
C2 - 22146054
SN - 0007-1048
VL - 156
SP - 374
EP - 382
JO - British journal of haematology
JF - British journal of haematology
IS - 3
ER -