A COMPARISON OF THE FIBRINOLYTIC ENZYME SYSTEM IN MATERNAL AND UMBILICAL-CORD BLOOD
Studies of the fibrinolytic enzyme system in the plasma of mothers and the newborn infants are reported and the results compared. All mothers had elevated levels of fibrinogen in the plasma at the time of delivery. The levels of fibrinogen in the newborn infants fell into a low normal range. Premature infants tended to have slightly lower levels of fibrinogen than term infants, with certain exceptions which are discussed. A direct correlation of values for fibrinogen with the birth weight could not be established. No correlation was observed between fibrinogen levels in mothers and infants, indicating that significant placental transfer of fibrinogen does not occur under normal conditions and that fibrinogen is manufactured by the fetus itself. All mothers had higher levels of free and total profibrinolysin in the plasma than did the infants. The differences were found to be highly significant. The levels of free profibrinolysin in premature infants did not vary as much from those of the term babies, as was the case with total profibrinolysin. The levels of total profibrinolysin show a definite trend upward with increasing birth weight. Inhibitors of the fibrinolytic enzyme system were also significantly higher in mothers than in infants. Premature infants had significantly lower levels than term infants although considerable overlapping in the range was noted. Evidence was obtained that small amounts of an active proteolytic enzyme are present in the euglobulin fraction of the mother at delivery even after the course of a normal labor. No hemorrhagic manifestations were observed, presumably because of the high levels of inhibitor in maternal blood. In contrast, lysis of clots was observed more frequently in samples of cord blood, possibly due to lower levels of inhibitor. Placental transfer of various decomposition products of protein apparently exists as indicated by measurements of trichloracetic acid-soluble products in samples of plasma. A possible relation between the low proteolytic activity of the plasma of premature infants and the high incidence of fatality from hyaline membrane disease in these infants is proposed and discussed.