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

Saber, Amira M; Aziz, Shereen P; Almasry, Al Zahraa E; Mahmoud, Walaa H.

doi:10.1186/s13052-021-00965-1

Cited by 6 publications

(6 citation statements)

References 26 publications

(41 reference statements)

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“…The incidence rate of IVH in neonates with very severe thrombocytopenia (point estimate: 22.7%, 95% CI: 14.8%–30.7%) was similar to that in neonates with severe thrombocytopenia (point estimate: 11.7%, 95% CI: 3.3%–20.0%) [ 5 , 19 ]. However, the trend that lower platelet counts were correlated with a higher 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 ].…”

Section: Discussionsupporting

confidence: 91%

“…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 ].…”

Section: Discussionmentioning

confidence: 99%

“…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 – 24 ]. The rate of PT varies from 39 to 72% in neonates with severe thrombocytopenia in different NICUs [ 7 , 16 , 22 , 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have demonstrated that an increased number of PTs are associated with a higher mortality risk [ 5 , 7 , 16 , 21 – 24 ]. The rate of PT varies from 39 to 72% in neonates with severe thrombocytopenia in different NICUs [ 7 , 16 , 22 , 22 , 23 ]. In our study, one or more PTs were administered to 57 (33.5%) neonates with severe thrombocytopenia.…”

Section: Discussionmentioning

confidence: 99%

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Bleeding in neonates with severe thrombocytopenia: a retrospective cohort study

et al. 2022

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Background Severe neonatal thrombocytopenia is a rare disease with multiple etiologies. Severe thrombocytopenia with bleeding is life-threatening and has attracted significant attention from clinicians. However, only a few studies have focused on the association between severe thrombocytopenia and bleeding. Thus, this study aimed to describe the neonates’ postnatal age at which severe thrombocytopenia was first recognized, clinical characteristics, bleeding patterns, and outcomes and to evaluate the association between minimum platelet count and bleeding. Methods A single-center retrospective cohort study for neonates with severe thrombocytopenia (platelet count ≤ 50 × 109/L) was conducted. Neonates who were admitted to our neonatal intensive care unit between October 2016 and February 2021 and developed severe thrombocytopenia were analyzed. Data were collected retrospectively until the patients were referred to other hospitals, discharged, or deceased. Results Among the 5819 neonatal inpatients, 170 with severe thrombocytopenia were included in this study. More than 30% of the patients had severe thrombocytopenia in the first 3 days of life. Among the 118 neonates with bleeding, 47 had more than one type of pathological bleeding. Neonates with very severe thrombocytopenia (point estimate: 53.7%, 95% confidence interval [CI]: 44.2%–63.1%) had a higher incidence rate of cutaneous bleeding than those with severe thrombocytopenia (point estimate: 23.4%, 95% CI: 12.3%–34.4%). The gestational age (median: 36.2 [interquartile range [IQR]: 31.4–39.0] weeks) and birth weight (median: 2310 [IQR: 1213–3210] g) of the major bleeding group were the lowest among no bleeding, minor bleeding, and major bleeding groups. Regression analysis controlled for confounders and confirmed that a lower platelet count (odds ratio [OR]: 2.504 [95% CI: 1.180–5.314], P = 0.017) was associated with a significant increase in the rate of bleeding. Very severe thrombocytopenia (point estimate: 49.1%, 95% CI: 39.6%–58.6%) had a higher rate of platelet transfusion than severe thrombocytopenia (point estimate: 5.7%, 95% CI: 0.7%–10.7%). The mortality rate was higher in neonates with bleeding than in those without bleeding (point estimates with 95% CI: 33.1% [24.4%–41.7%] vs. 7.7% [0.2%–15.2%]). Conclusions These findings describe the incidence of severe thrombocytopenia and demonstrate that a lower platelet count is associated with an increased bleeding rate in patients with severe thrombocytopenia.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bleeding in neonates with severe thrombocytopenia: a retrospective cohort study

et al. 2022

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“…Severe neonatal thrombocytopenia was present in 34.4% of cases [2]. In previous study, 20% of cases was classified as severe neonatal thrombocytopenia [4,5]. However, in large cohort study including 11,281 term infants in NICU, severe neonatal thrombocytopenia was only identified in 2.4% due to the high incidence of sepsis [3,6].…”

Section: Introductionmentioning

confidence: 86%

Risk factors of thrombocytopenia in term infants in Prof. Dr. I.G.N.G. Hospital Denpasar Bali

Artana¹,

Kardana²,

Artana³

et al. 2022

GSC Adv. Res. Rev.

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Thrombocytopenia is a condition in which platelet count below 150 x 109/L. Neonatal thrombocytopenia (NT) accounts up to 35% of all patients admitted to neonatal intensive care unit (NICU). The underlying cause of NT can often be predicted by the onset time of thrombocytopenia and course of disease. The purpose of this study was to determine the risk factors of thrombocytopenia in term infants undergoing treatment at Prof. Dr. I.G.N.G. Hospital. Method: An observational analytical study using case-control design was conducted in 50 term infants from March 2021 to October 2021 in Prof. Dr. I.G.N.G. Hospital Denpasar Bali. Result: Total 25 infants with thrombocytopenia in case group and 25 infants without thrombocytopenia in control group. Most of the infants were dominated by female gender (54%), mean gestational age was 38 (± 1) weeks, birth weight 2,940 (± 445) gram, cesarean section (56%). In addition, 48% of patients were vigorous babies. Early-onset neonatal sepsis (EOS) was 76% and late-onset neonatal sepsis (LOS) was 14%, most infants had neonatal pneumonia 58% and necrotizing enterocolitis (NEC) 48%. Mothers with preeclampsia were 26%. Multivariate analysis showed EOS was risk factor for NT (OR 4.69; 95% CI 0.9 – 22.0) and NEC (OR 4.17; 95% CI 1.2 – 14.4). Conclusion: Early onset neonatal sepsis (EOS) and necrotizing enterocolitis (NEC) are risk factors for thrombocytopenia in term infants.

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Most major bleeds in preterm infants occur in the absence of severe thrombocytopenia: an observational cohort study

van der Staaij,

Hooiveld,

Caram-Deelder

et al. 2024

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo describe the incidence of major bleeds according to different platelet counts in very preterm infants, and to explore whether this association is influenced by other risk factors for bleeding.DesignObservational cohort study.SettingA Dutch tertiary care neonatal intensive care unit.PatientsAll consecutive infants with a gestational age at birth <32 weeks admitted between January 2004 and July 2022.ExposureInfants were stratified into nine groups based on their nadir platelet count (×109/L) during admission (<10, 10–24, 25–49, 50–99, 100–149, 150–199, 200–249, 250–299 and ≥300), measured before the diagnosis of a major bleed and before any platelet transfusion was administered.Main outcome measureIncidence of major bleeds during admission. Logistic regression analysis was used to quantify the relationship between nadir platelet count and incidence of major bleeds.ResultsAmong 2772 included infants, 224 (8%) developed a major bleed. Of the infants with a major bleed, 92% (206/224) had a nadir platelet count ≥50×109/L. The incidence of major bleeds was 8% among infants with and without severe thrombocytopenia (platelet count <50×109/L), 18/231 (95% CI 5 to 12) and 206/2541 (95% CI 7 to 9), respectively. Similarly, after adjustment for measured confounders, there was no notable association between nadir platelet counts below versus above 50×109/L and the occurrence of major bleeds (OR 1.09, 95% CI 0.61 to 1.94).ConclusionIn very preterm infants, the vast majority of major bleeds occur in infants without severe thrombocytopenia.

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

Cited by 6 publications

References 26 publications

Bleeding in neonates with severe thrombocytopenia: a retrospective cohort study

Bleeding in neonates with severe thrombocytopenia: a retrospective cohort study

Risk factors of thrombocytopenia in term infants in Prof. Dr. I.G.N.G. Hospital Denpasar Bali

Most major bleeds in preterm infants occur in the absence of severe thrombocytopenia: an observational cohort study

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