A neonate may suffer an ischemic stroke if certain perinatal conditions are present.


Hypercoagulable state in either the mother or fetus:

(1) Factor V Leiden (G1691A), which is associated with Activated Protein C (APC) Resistance

(2) Prothrombin G20210A

(3) protein C deficiency

(4) protein S deficiency

(5) antithrombin III deficiency

(6) lipoprotein(a)

(7) elevated homocysteine

(8) lupus anticoagulant

(9) antiphospholipid antibody

(10) fibrinogen(Clauss)

(11) plasminogen defect

(12) Factor VIIIc


Infection in the fetus related to:

(1) chorioamnionitis

(2) meningitis

(3) prolonged rupture of the membranes

(4) other infection


Fetal factors:

(1) black race

(2) male gender

(3) polycythemia

(4) twin-twin transfusion

(5) congenital heart disease

(6) dehydration

(7) mutation in procollagen IVa1

(8) pulmonary hypertension

(9) neonatal hypoglycemia

(10) extracorporal membrane oxygenation (ECMO)

(11) intrauterine growth retardation


Maternal factors:

(1) infertility therapy

(2) autoimmune disease

(3) preeclampsia or eclampsia



• A mild protein S deficiency occurs during pregnancy.

• Screening the mother for cocaine and/or methamphetamine abuse may be considered if all of the above are absent.


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