HEPARIN AND THE RISK OF INTRAVENTRICULAR HEMORRHAGE IN PREMATURE-INFANTS

Objective: This study was carried out to determine whether the routine use of low-dose heparin in umbilical catheter infusates increases the risk of intraventricular hemorrhage or alters the coagulation profile in premature infants. Methods: In a randomized, blinded trial, 113 in fants born at less than 31 weeks' gestation were assigned to receive, in their umbilical catheter infusate, either 1 unit of heparin per mil liliter (n = 55) or no heparin (n = 58). Prothrombin time, activated p artial thromboplastin time, fibrinogen concentration, and antithrombin III activity levels were determined at the start and the completion o f the study. Cranial ultrasonography was performed during the first we ek of life. Results: There was no difference in the incidence of intra ventricular hemorrhage between the heparin and no heparin groups, 35.8 % and 31.5%, respectively (p = 0.6). Similarly, no difference was dete cted in the incidence of severe intraventricular hemorrhage (grades II I/IV). Prothrombin time, activated partial thromboplastin time, and fi brinogen levels were not significantly different between the two group s. However, the use of heparin was associated with a lower antithrombi n III activity level. Antenatal indomethacin use was associated with a 2.9 increased risk of intraventricular hemorrhage (95% confidence int erval, 1.15 to 7.17). Conclusion: A low dose of heparin added to umbil ical catheter infusates does not in crease the incidence or severity o f intraventricular hemorrhage or significantly alter the coagulation p rofile in premature infants.