Establishment of Reference Ranges for Coagulation Parameters in Neonates and Infants in Our Population
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Background: Coagulation reference intervals vary with developmental age, laboratory method, reagent system, and population characteristics; therefore, adult-based reference values may not be appropriate for interpreting haemostatic parameters in neonates and infants. Objective: To establish local reference intervals for selected coagulation parameters among healthy Pakistani neonates and infants. Methods: This multicentre descriptive cross-sectional study was conducted from January to December 2021 through Combined Military Hospital Quetta, with recruitment from EPI vaccination centres of Combined Military Hospitals in Rawalpindi, Quetta, Lahore, Multan, and Karachi. Healthy neonates and infants aged from birth to less than one year were enrolled after parental consent. Venous blood samples were collected in trisodium citrate tubes and analysed for platelet count, prothrombin time, activated partial thromboplastin time, thrombin time, and fibrinogen. Reference intervals were estimated using the 2.5th and 97.5th percentiles. Results: A total of 470 participants were included, comprising 312 males and 158 females. The overall reference intervals were 10–15 seconds for prothrombin time, 21–37 seconds for activated partial thromboplastin time, 13–20 seconds for thrombin time, and approximately 205–410 mg/dL for fibrinogen. Platelet count showed the clearest age-related difference, with higher mean values among infants than neonates. Conclusion: Locally derived coagulation reference intervals may improve interpretation of neonatal and infant haemostatic screening in Pakistan
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