Risk factors for severity of thrombocytopenia in full term infants: a single center study

Abstract

Background: Neonatal thrombocytopenia (NT) (platelet count <150 x 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, rick factors, and outcomes of severe NT in full term (FT) infants.Methods: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.Results: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P=0.001) and had higher rates of mortality (P=0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P=0.001).Conclusion: Severe NT occurred in 52.73% of cases. The most common cause of NT was neonatal sepsis, followed by a postoperative state. Furthermore, severe NT, when compared to mild/moderate NT associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions and had increased mortality.

Bleeding in neonates with severe thrombocytopenia: a retrospective cohort study

“…GA and BW were not negatively associated with the incidence of severe thrombocytopenia, as mentioned in previous studies [4,5,11]. Sepsis is the most frequent cause of thrombocytopenia, as reported in several studies [16,17]. The higher incidence of total hemorrhage in neonates with severe thrombocytopenia discovered in our study was similar to that reported in the literature [10].…”

“…2 The lowest platelet counts in neonates with and without bleeding during study. Lines represent median with interquartile ranges incidence of IVH was consistent with the findings of Bolat et al [7] and Saber et al [16]. However, it remains uncertain whether thrombocytopenia causes IVH before the occurrence of thrombocytopenia [4,5].…”

“…PT has long been considered a common therapeutic or preventative measure to reduce bleeding in neonates with severe thrombocytopenia; however, it is also associated with risks [4,17]. Several studies have demonstrated that an increased number of PTs are associated with a higher mortality risk [5,7,16,[21][22][23][24]. The rate of PT varies from 39 to 72% in neonates with severe thrombocytopenia in different NICUs [7,16,22,22,23].…”

Association of anemia and platelet activation with necrotizing enterocolitis with or without sepsis among low birth weight neonates: a case–control study

“…Damage to vascular endothelium caused by bacteria is repaired by PLTs, resulting in increased platelet consumption, activated immune system, and promoted PLT apoptosis 33 . Other common viral infections, such as Torch or fungal infection, directly destroy the megakaryocytes or PLTs, inhibit bone marrow hematopoiesis, induce the production of autoantibodies to accelerate PLT destruction and affect their levels in peripheral blood.…”

Prevalence, risk factors, severity and outcome of neonatal thrombocytopenia.

“…3 Development of TCP among neonates is complex and depends upon various maternal and fetal conditions. 4 Most commonly linked conditions with TCP are sepsis, birth asphyxia, low birth-weight (LBW), prematurity, necrotizing colitis, exchange transfusion while maternal factors include hypertension and idiopathic thrombocytopenic purpura. 5 Sepsis is found to be the commonest cause of TCP and it aggravates within 24 to 48 hours following the infective process.…”