Mature and immature platelets during the first week after birth and incidence of patent ductus arteriosus

Abstract

Background:Thrombocytopenia is a risk factor for patent ductus arteriosus. Immature and mature platelets exhibit distinct haemostatic properties; however, whether platelet maturity plays a role in postnatal, ductus arteriosus closure is unknown.Methods:In this observational study, counts of immature and mature platelets (=total platelet count − immature platelet count) were assessed on days 1, 3, and 7 of life in very low birth weight infants (<1500 g birth weight). We performed echocardiographic screening for haemodynamically significant patent ductus arteriosus on day 7.Results:Counts of mature platelets did not differ on day 1 in infants with (n = 24) and without (n = 45) haemodynamically significant patent ductus arteriosus, while infants with significant patent ductus arteriosus exhibited lower counts of mature platelet on postnatal days 3 and 7. Relative counts of immature platelets (fraction, in %) were higher in infants with patent ductus arteriosus on day 7 but not on days 1 and 3. Receiver operating characteristic curve analysis unraveled associations between both lower mature platelet counts and higher immature platelet fraction (percentage) values on days 3 and 7, with haemodynamically significant ductus arteriosus. Logistic regression analysis revealed that mature platelet counts, but not immature platelet fraction values, were independent predictors of haemodynamically significant patent ductus arteriosus.Conclusion:During the first week of postnatal life, lower counts of mature platelets and higher immature platelet fraction values are associated with haemodynamically significant patent ductus arteriosus. Lower counts of mature platelet were found to be independent predictors of haemodynamically significant patent ductus arteriosus.

Useful Platelet Indices for the Diagnosis and Follow-Up of Patent Ductus Arteriosus

“…Although there are studies in the literature suggesting that thrombocytopenia on the first postnatal day is an important risk factor for hsPDA, 6,[9][10][11] other studies have shown that it has no effect. [12][13][14][15][16][17] Various studies investigating the relationship between platelet indices and hsPDA identified increased platelet distribution width (PDW), [11][12][13] high mean platelet volume (MPV) and low platelet mass, 15 and high red cell distribution width (RDW) to platelet ratio (RPR) 12 as risk factors for hsPDA. However, two other studies found no correlation between hsPDA and indices such as PDW, MPV, and platelet mass.…”

“…However, two other studies found no correlation between hsPDA and indices such as PDW, MPV, and platelet mass. [14][15][16][17] The few studies conducted on this subject have provided conflicting results.…”

Trombocitopenia como indicador predictivo de cierre deficitario de ductus arterioso en prematuros del Instituto Nacional Materno Perinatal

“…Estos resultados concuerdan con dos metaanálisis 3,4 y con casos y controles como el de Almayac 6 en el 2012, quien encontró un OR: 2.68 y cohortes retrospectivas como el de Dani 10 en el 2013 quien encontró un OR de 4.5. Esto, a diferencia de estudios como el de Akar y col 7 Murphy y col 8 , Bas Suarez y col 5 y Sallmon y col 9 ; quienes encontraron resultados discordantes a los nuestros.…”

A Correlative Study of Hemodynamically Significant Patent Ductus Arteriosus and Platelets within 24 hours of Birth in Preterm Infants

“…Therefore, it has been speculated that the platelets in the circulation cannot help PDA closure and PLT also has no exact logic relationship with PDA closure, which is just a statistical correlation [9]. Recently, a large two-center retrospective cohort analysis was carried out on 1350 infants with very low birth weight in Germany, and the statistics showed that PLT within 24 h after birth had no relationship with the presence of PDA by the echocardiography examination within 4-5 days after birth [12]. The impaired platelet function rather than the reduction in PLT may have a certain relationship with the PDA.…”

“…Thus, with regard to the relationship between the thrombocytopenia and the incidence of PDA, there was still a large dispute. The reasons for the great difference among these research findings were still unclear, which could not be explained by the possible existence of difference in the neonatal intensive care unit (NICU) management [12]. It was recommended that a prospective study should be carried out to solve these disputes [9].…”