Thrombocytopenia in neonates: causes and outcomes

Abstract

Thrombocytopenia is one of the most common hematological abnormalities found in neonates. The causes, treatment modalities, and outcomes of neonatal thrombocytopenia have to be evaluated for providing better care and follow-up. In this study, our aim was to assess the prevalence, causes, treatment modalities, and outcomes of thrombocytopenia in neonates. A retrospective analysis was conducted on the medical records of all neonates hospitalized at our hospital between January 2007 and December 2011 and those with thrombocytopenia were included in the study. Of the 3,515 neonates, 134 (3.8%) had thrombocytopenia. Ninety-seven of them (72%) were preterm. In the patients admitted to neonatal intensive care unit, the prevalence of thrombocytopenia was found as 12%, whereas it was found as 1.2% in neonatal service. The highest prevalence was detected in the year 2008 by 5.3%, and the lowest prevalence was detected in the year 2011 by 2.4%. Sepsis was the most common etiologic factor between years 2007 and 2009. Intrauterine growth restriction, metabolic disorders, drugs, and asphyxia were more common causes in the recent years. Severe thrombocytopenia was found in 26% of neonates and 11 % of thrombocytopenic neonates had major hemorrhage. Intracranial hemorrhage ratio was 5.9% and all of these patients were preterm. Thrombocytopenia improved in 92.5% of patients and persisted in 3% of patients. Death occurred in 4.5% of neonates. This study shows that the causes of neonatal thrombocytopenia may show variations with respect to time and the prevalence, complications, and risks of thrombocytopenia may be lowered by eliminating preventable factors.

Neonatal thrombocytopenia—causes and outcomes following platelet transfusions

“…Our sepsis rate associated with NT was higher than reported by Ulusoy et al [7] and von Lindern et al [11]: 47% compared with 30 and 36%, respectively. The finding that severe and very severe NT were significantly associated with sepsis was again confirmed by von Lindern et al [11].…”

“…The degree of thrombocytopenia was defined as follows: mild, a platelet count of 100,000 to 150,000/μL; moderate, a platelet count of 50,000 to < 100,000/μL; severe, a platelet count of 30,000 to < 50,000/μL; and very severe, a platelet count of < 30,000/μL [6]. Neonatal thrombocytopenia has been categorized into two groups depending on the time of onset: early onset (EOT), which is within 72 h of life and late onset (LOT), after 72 h of life [7, 8]. The duration of NT was defined as the time from diagnosis to normalization (values above 150,000/μL).…”

Early-Onset Thrombocytopenia in Small-for-Gestational-Age Neonates: A Retrospective Cohort Study

“…Our findings show that the incidence of thrombocytopenia is 2.7 times higher in SGA neonates compared to a group of AGA neonates matched for gestational age at birth, which is in agreement several other studies. [2,3,7,14,20] The strength of this study, besides being one of the largest studies on early onset thrombocytopenia in SGA neonates, is the study design with a control group matched for gestational age at birth. Matching for gestational age allowed for a more accurate comparison between the two groups (SGA and AGA) by eliminating the important confounding effect of prematurity.…”

“…One of the most frequent causes of early-onset thrombocytopenia is intrauterine growth restriction and it is therefore often detected in small for gestational age (SGA) neonates. [2][3][4]7] In SGA neonates, early-onset thrombocytopenia is thought to result from increased platelet consumption in the placenta due to increased blood flow resistance and/or result from suppressed platelet production due to increased red cell production. [8,9] Not all SGA neonates develop thrombocytopenia, and severity varies, therefore other factors are thought to play an etiological role as well.…”

“…[1][2][3][4][5][6][7] The causes of neonatal thrombocytopenia vary according to the underlying disease and can be classified according to the time at onset. Early-onset thrombocytopenia occurs within 3 days after birth, whereas late-onset thrombocytopenia occurs more than 3 days after birth.…”