COAGULOPATHIES AS A CAUSE OF DEATH IN INFANTS UNDER ONE YEAR OF AGE IN BRAZIL

@article{cury2026coagulopathies,
  title = {{COAGULOPATHIES AS A CAUSE OF DEATH IN INFANTS UNDER ONE YEAR OF AGE IN BRAZIL}},
  author = {Victor Borsani Salomão CURY},
  journal = {Hematology, Transfusion and Cell Therapy},
  year = {2026},
  month = oct,
  doi = {10.1016/j.htct.2026.108356},
  url = {https://doi.org/10.1016/j.htct.2026.108356},
  note = {CC BY},
}

TY  - JOUR
TI  - COAGULOPATHIES AS A CAUSE OF DEATH IN INFANTS UNDER ONE YEAR OF AGE IN BRAZIL
AU  - Victor Borsani Salomão CURY
PY  - 2026
DA  - 2026/10/23
JO  - Hematology, Transfusion and Cell Therapy
DO  - 10.1016/j.htct.2026.108356
UR  - https://doi.org/10.1016/j.htct.2026.108356
AB  - Objective: Coagulopathies encompass congenital disorders, including hereditary deficiencies of coagulation factors and qualitative platelet defects, and acquired conditions, of which disseminated intravascular coagulation (DIC) is the most frequent. DIC results from unregulated systemic activation of the coagulation cascade and produces endothelial injury and multiorgan dysfunction. Although infrequent in childhood, coagulopathies carry substantial morbidity and mortality, particularly among critically ill patients, and pediatric data on the incidence and severity of DIC are limited. Characterizing the distribution of coagulopathies in the first year of life in Brazil and their contribution to mortality is essential to plan the care of patients at risk. This study aimed to estimate the burden of coagulopathies as a cause of death among Brazilian infants under one year of age between 2014 and 2024, using mortality rates and proportional mortality. Material and Methods: Death records were retrieved from the Mortality Information System of the Brazilian Ministry of Health (SIM/DATASUS), and population denominators from the Brazilian Institute of Geography and Statistics (IBGE). An ecological time-series design was applied to estimate mortality rates and proportional mortality attributable to coagulopathies, defined according to the International Classification of Diseases, 10th revision (ICD-10), Chapter III, codes D65 through D69, and to all causes of death in infants under one year of age in Brazil between 2014 and 2024. Results: During the study period, 399,873 infant deaths were recorded. Diseases of the blood and blood-forming organs ranked eleventh among the causes of death before one year of age; within this chapter, coagulopathies were the leading cause and accounted for 33% of deaths. The postneonatal period concentrated 74.6% of coagulopathy-related deaths, and the early and late neonatal periods accounted for 10.8% and 14.6%, respectively. The coagulopathy-specific mortality rate was 2.10 per 100,000 live births, and proportional mortality relative to all-cause deaths was 0.17%. DIC accounted for the largest share of these deaths (43.8%), followed by other coagulation defects (40.1%), purpura and other hemorrhagic conditions (15.1%), hereditary factor VIII deficiency (0.8%), and hereditary factor IX deficiency (0.2%). Discussion: DIC emerged as the leading cause of coagulopathy-related death in this age group. Its precipitating factors are multiple; in this population, infection predominates, followed by severe tissue injury, shock, and malignancy. Among hereditary coagulopathies, mortality reflects diagnostic delay and restricted access to clotting factor concentrates for prophylaxis and on-demand replacement, and hemorrhage without prompt treatment may evolve to severe complications, including death. Data from 2024 indicate that the prevalence of diagnosed coagulopathies rises with age, with 44 affected individuals below one year of age and a peak in late adolescence, a pattern consistent with delayed recognition. Conclusion: Because infection is the principal trigger of DIC, which in turn is the main cause of coagulopathy-related death in infancy, prompt and effective management of the underlying condition is the central measure to avert fatal outcomes. Knowledge of the epidemiological profile of infant mortality is essential for strengthening health care and reducing deaths in this age group.
SN  - 2531-1379
SN  - 2531-1387
ER  -