Iranian Journal of Neonatology

Iranian Journal of Neonatology

Neonatal Bleeding: A Single-center Egyptian NICU Cross-Sectional Study

Document Type : Original Article

Authors
Magy Abdelwahab 1
Zahraa Mohamed Ezz eldin 1
Mervat Mohamed Elansary 2
Kareeman Gomaa Mohammed 2
Amira Mahmoud Gad 1
Yasmeen M.M. Selim 3
1 Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
2 Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
3 Department of Pediatrics, Pediatric Hematology and Bone Marrow Transplantation, Kasr Alainy Faculty of Medicine, Cairo University, Giza, Egypt
10.22038/ijn.2026.90811.2762
Abstract
Background: Neonatal bleeding disorders can be quite challenging in neonatal intensive care units (NICUs) and are often linked to primary or secondary haemostatic defects. In Egypt, the high prevalence of rare inherited bleeding disorders (RIBDs) is attributed to consanguinity and close community marriages. We aimed to evaluate the bleeding phenotype of a neonatal cross-section and to assess the usefulness of the International Society for Thrombosis and Haemostasis bleeding assessment tool (ISTH-BAT) in identifying neonates with potential RIBDs.
Methods: A cross-sectional research was conducted over one year, including all neonates (n = 61) with any bleeding symptom/s admitted to Cairo University Hospital NICU. Clinical evaluations, laboratory testing (CBC, PT, aPTT, INR, TT, fibrinogen, factor VII), and ISTH-BAT scoring were performed.
Results: Upper gastrointestinal tract (36.1%) and pulmonary (19.7%) hemorrhages were the most common bleeding sites. Our study was separated into 2 groups: healthy (n = 10) and unhealthy (n = 51). An abnormal ISTH-BAT score (≥ 3) was found in 42.6% and was significantly higher among septic neonates (p-value = 0.013). Among the healthy group, 7 had vitamin K deficiency bleeding (VKDB) and 3 had afibrinogenemia, the latter showing the highest ISTH-BAT scores (7–8).
Conclusion: VKDB and sepsis were the commonest causes of bleeding in healthy and unhealthy neonates, respectively. Bleeding due to afibrinogenemia represented 4.9% and 30% of the whole cross-sectional study and healthy neonates, respectively. The ISTH-BAT can be a useful screening tool for assessing significant bleeding in neonates, particularly identifying those with RIBDs.
Keywords
Afibrinogenemia
Neonatal bleeding
Neonatal sepsis
Vitamin K
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Iranian Journal of Neonatology
Volume 17, Issue 3
Summer 2026
Pages 30-36