How I diagnose and treat neonatal thrombocytopenia

Stanworth, Simon J; Mumford, Andrew D

doi:10.1182/blood.2022018017

Cited by 5 publications

(3 citation statements)

References 120 publications

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“…Thrombocytopenia is the most frequent hematological issue found in newborns, excluding anemia caused by phlebotomy [12,13]. It is particularly common in NICUs, which might lead some to dismiss it as a non-issue and simply administer platelet transfusions when the count drops below a certain level [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

The Prevalence and Associated Risk Factors for Neonatal Thrombocytopenia Among Newborns Admitted to the Neonatal Intensive Care Unit

Al Ghadeer,

Aldhahi,

Al Dandan

et al. 2024

Cureus

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BackgroundThrombocytopenia is the most prevalent hematological condition in neonates that develops in the neonatal intensive care unit (NICU). This set of illnesses is caused by either decreased platelet production due to placental insufficiency, increased platelet breakdown (consumption), or a combination of the two causes. Based on platelet count, it is defined as mild, moderate, or severe thrombocytopenia, with early and late onset. PurposeThe purpose of this study is to determine the prevalence of thrombocytopenia and the factors that contribute to it in newborns hospitalized in the neonatal critical care unit at the Maternity and Children Hospital in Al Ahsa, Saudi Arabia. MethodsThis descriptive retrospective cross-sectional study was carried out at the NICU of the Maternity and Children Hospital in Al Ahsa, Saudi Arabia, over the span of one year (August 2022 to August 2023) among hospitalized neonates with thrombocytopenia. Thrombocytopenia is defined as a platelet count of 150,000 or less. These patients were monitored until they recovered or died. ResultsThe inclusion criteria were met by a total of 242 newborns with thrombocytopenia. Half of the neonates (57%) were full-term, with Apgar scores greater than 5 at the first (84%) and fifth (93%) minutes, respectively. The great majority of individuals (84%) experienced early-onset thrombocytopenia of mild severity (62%) and were asymptomatic (93%). The majority of the cases resolved spontaneously, with only 21% requiring platelet transfusion. There was a significant relationship discovered between gestational age and the severity of thrombocytopenia, with very preterm infants having moderate to severe thrombocytopenia, as well as birth weight (p=0.001). Furthermore, neonates with severe thrombocytopenia had a considerably higher mortality rate (p=0.001). ConclusionThe mortality and morbidity of newborns with perinatal risk for neonatal thrombocytopenia can be reduced with timely detection of the cause and development of thrombocytopenia, as well as adequate and early care.

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Section: Discussionmentioning

confidence: 99%

The Prevalence and Associated Risk Factors for Neonatal Thrombocytopenia Among Newborns Admitted to the Neonatal Intensive Care Unit

Al Ghadeer,

Aldhahi,

Al Dandan

et al. 2024

Cureus

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“…The incidence of thrombocytopenia in neonates admitted to the neonatal intensive care unit (NICU) can range from 22-35% 2,3 . Chronic fetal hypoxia resulting from pregnancy-induced hypertension (PIH) is the primary cause of earlyonset neonatal thrombocytopenia within 72 hours after birth [4][5][6] . PIH comprises gestational hypertension, preeclampsia, and eclampsia, which can cause an imbalance in the blood systems of mothers and neonates [7][8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Effects of Pregnancy-Induced Hypertension on Early-Onset Neonatal Thrombocytopenia

Zhou

et al. 2023

Preprint

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Background Gestational hypertension and preeclampsia are potentially linked to similar pathophysiological processes. Maternal preeclampsia increases the occurrence of early-onset neonatal thrombocytopenia. We hypothesized that maternal gestational hypertension would likewise impact the incidence of early-onset neonatal thrombocytopenia. Therefore, we conducted a retrospective study to validate our hypothesis. Methods In this study, we included 538 neonates, comprising 318 and 220 neonates born to healthy mothers and those with pregnancy-induced hypertension (PIH), respectively. The minimum platelet count within 72 hours of birth was recorded for these neonates. The incidence of early-onset thrombocytopenia in neonates in relation to maternal gestational hypertension, preeclampsia, and health status was evaluated. The differences between the three groups were analyzed using the chi-square test. Logistic regression analysis was conducted to assess the relationship between maternal gestational hypertension or preeclampsia and the risk of early-onset neonatal thrombocytopenia. Results The incidence of early-onset thrombocytopenia in neonates born to mothers with preeclampsia was significantly higher than in those born to mothers with gestational hypertension or healthy mothers. Significant differences were observed between the three groups (30.0% vs. 13.3% vs. 7.9%, P < 0.001). Maternal gestational hypertension (OR=2.55, 95% CI 1.10–5.91, P < 0.05) and preeclampsia (OR=2.41, 95% CI 1.18–4.93, P <0.05) increased the risk of early-onset neonatal thrombocytopenia when compared to healthy mothers. Conclusions Our findings suggest that maternal gestational hypertension increases the occurrence of early-onset neonatal thrombocytopenia. Therefore, we recommend conducting platelet count screening in the early stages for newborns of mothers with gestational hypertension.

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“…Intracranial hemorrhage (ICH) is an important cause of neonatal morbidity and mortality (6). IHC can be particularly harmful in the neonatal period as this is a critical stage for brain development (7,8). Reported cases of WAS that start with ICH are rare.…”

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confidence: 99%

Wiskott-Aldrich syndrome: A new synonym mutation in the WAS gene

Sun,

Song,

Pan

et al. 2024

IRDR

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Wiskott-Aldrich syndrome, synonymous mutation, newborn, hematopoietic stem cell transplantation, intracranial hemorrhage Wiskott-Aldrich syndrome (WAS) is a rare X-linked recessive primary immunodeficiency disorder. Mutations in the WAS gene are considered to be the primary cause of WAS. In this work, we report a boy who presented with intracranial hemorrhage (ICH) as an initial symptom and detects a novel pathogenic synonymous mutation in his WAS gene. His mother was a carrier of the mutant gene. The mutation, located at position c.273 (c.273 G>A) in exon 2, is a synonym mutation and predicted to affect protein expression by disrupting gene splicing. This study summarizes the diagnosis and treatment process of the patient and expands the genetic spectrum of WAS.

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How I diagnose and treat neonatal thrombocytopenia

Cited by 5 publications

References 120 publications

The Prevalence and Associated Risk Factors for Neonatal Thrombocytopenia Among Newborns Admitted to the Neonatal Intensive Care Unit

The Prevalence and Associated Risk Factors for Neonatal Thrombocytopenia Among Newborns Admitted to the Neonatal Intensive Care Unit

Effects of Pregnancy-Induced Hypertension on Early-Onset Neonatal Thrombocytopenia

Wiskott-Aldrich syndrome: A new synonym mutation in the WAS gene

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