Evaluation of platelet function by Total Thrombus-Formation Analysis System (T-TAS®01) in term and preterm infants and its relationship with patent ductus arteriosus. A prospective observational pilot study

Background: Newborns exhibit a pro-coagulant hemostatic profile despite platelet hyporeactivity and reduced coagulation factors. Assessing infant hemostasis, particularly in preterm infants, is challenging, with inconsistent findings regarding the relationship between platelet count and function in patients with patent ductus arteriosus (PDA). Materials and methods: This study aims to assess platelet function using the Total Thrombus-Formation Analysis System (T-TAS®01) in term and preterm newborns. T-TAS®01 measures the Occlusion Start Time (OST), Occlusion Time (OT), and the Area Under the Curve (AUC) at the end of thrombus formation. The study includes term and preterm newborns below 30 weeks' gestational age (GA) admitted to the Neonatal Intensive Care Unit. Blood samples were collected from preterm newborns on the 1st day of life (T0), between 48-72 hours of life (T1), between the 7th and 10th day of life (T2), and from term newborns at T0 and T2. Secondary endpoints include the relationship between T-TAS®01 parameters and significant PDA in preterm newborns and the correlation between T-TAS®01 parameters, GA, and complete blood count (CBC). Results: OST is delayed by 65.5 seconds in preterm infants at T0 (p<0.001) and by 46 seconds at T2 (p=0.041) compared to full-term newborns. OT is delayed by 164 seconds in preterm infants at T0 (p=0.002) and by 352 seconds at T2 (p=0.002). AUC at T0 is lower in preterm infants (p=0.028). There is no significant correlation between T-TAS®01 parameters and GA or CBC. Additionally, OST and OT are delayed, and AUC is reduced in preterm infants with PDA and hemodynamically significant PDA (hsPDA). Discussion: T-TAS®01 is a reliable tool for evaluating platelet function in term newborns. However, measurements show higher variability in preterm infants, with significantly lower platelet activity observed in preterm infants with PDA and hsPDA.