Thrombopoiesis in small for gestational age newborns

Wasiluk, Alicja; Mantur, M; Kemona, H; Szczepański, Marek; Jasińska, Elwira; Milewski, Robert

doi:10.3109/09537100903207505

Cited by 21 publications

(16 citation statements)

References 23 publications

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“…had lower PLT and PCT compared with not SGA neonates as previously described [18,19]. Lower PLT in SGA indicates the immaturity of thrombopoiesis [20,21].…”

Section: Plos Onesupporting

confidence: 71%

Perinatal factors affecting platelet parameters in late preterm and term neonates

Ohto

Nollet

et al. 2020

PLoS ONE

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Platelets parameters including platelet count (PLT), plateletcrit (PCT), mean platelet volume (MPV) and platelet distribution width (PDW) are associated with various physiological and pathological functions in various disease. However, few studies have addressed whether perinatal factors may be associated with platelet parameters at birth in a large cohort of late preterm and term neonates. The aim of this study to investigate perinatal factors affecting platelet parameters in late preterm and term neonates. We retrospectively investigated platelet parameters including PLT, PCT, MPV, and PDW on the first day of life in 142 late preterm and 258 term neonates admitted to our NICU from 2006 through 2020. PLT, MPV, PCT, PDW on Day 0 did not significantly differ between the two groups. In term neonates, multivariate analysis revealed that PCT correlated with being small for gestational age (SGA) (β = -0.168, P = 0.006), pregnancy induced hypertension (PIH) (β = -0.135, P = 0.026) and male sex (β = -0.185, P = 0.002). PLT was associated with SGA (β = -0.186, P = 0.002), PIH (β = -0.137, P = 0.024) and male sex (β = -0.166, P = 0.006). In late preterm neonates, multivariate analysis revealed that PLT were associated with PIH, whereas no factors associated with PDW and MPV were found. In all patients studied, chorioamnionitis (CAM) was significantly associated with MPV (CAM = 10.3 fL vs. no CAM = 9.7 fL, P<0.001). Multivariate analysis showed that SGA, male sex and PIH were associated with PCT and PLT. This study demonstrates that different maternal and neonatal complications affect platelet parameters in late preterm and term neonates.

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“…had lower PLT and PCT compared with not SGA neonates as previously described [18,19]. Lower PLT in SGA indicates the immaturity of thrombopoiesis [20,21].…”

Section: Plos Onesupporting

confidence: 71%

Perinatal factors affecting platelet parameters in late preterm and term neonates

Ohto

Nollet

et al. 2020

PLoS ONE

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“…The majority of these are acquired varieties of consumptive thrombocytopenia accompanying bacterial or fungal sepsis or necrotizing enterocolitis [1,2,5,6]. Rare varieties of hyoregenerative thrombocytopenia accompany aneuploidy or syndromes involving thrombopoietic failure [1–3]. A separate variety of early thrombocytopenia has been described among neonates who are SGA.…”

Section: Discussionmentioning

confidence: 99%

Thrombocytopenia in Small-for-Gestational-Age Infants

et al. 2015

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BACKGROUND Thrombocytopenia is common among small for gestational age neonates (SGA; birth weight <10th % reference range) but several aspects of this thrombocytopenia are unclear, including the incidence, typical nadir, duration, association with preeclampsia, mechanism, and risk of death. METHODS Using nine years of multihospital records we studied SGA neonates with ≥2 platelet counts <150,000/μL in their first week. RESULTS We found first-week thrombocytopenia in 31% (905 of 2891) of SGA neonates vs. 10% of non-SGA matched-controls (p<0.0001). One hundred-two of the 905 had a recognized cause of thrombocytopenia (DIC, early-onset sepsis, ECMO). This group had a 65% mortality rate. The remaining 803 did not have an obvious cause for their thrombocytopenia. We termed these the “thrombocytopenia of SGA”. They had a mortality rate of 2% (p<0.0001) and a mean nadir count on day 4 of 93,000/μL (standard deviation, 51,580/μL, 10th % 50,000/μL, 90th % 175,000/μL). By day 14, platelet counts were ≥150,000/μL in >half of the patients. Severely SGA neonates (<1st %) had lower counts and longer thrombocytopenia duration (p<0.001). High nucleated red cell counts at birth correlated with low platelets (p<0.0001). Platelet transfusions were given to 23% and counts typically >tripled. Thrombocytopenia was associated with SGA status more so than with the diagnosis of maternal preeclampsia. CONCLUSIONS SGA neonates with clearly recognized varieties of thrombocytopenia have a high mortality rate. In contrast the “thrombocytopenia of SGA” is a hyporegenerative condition of moderate severity and two weeks duration, associated with evidence of intrauterine hypoxia, and associated with a low mortality rate.

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“…Wasiluk et al found significantly lower platelet counts in severe (p<5) compared to moderate (p5-10) SGA. [ 10 , 11 ] Van den Hof et al describe a correlation between fetal abdominal circumference and fetal platelet count. [ 21 ] Because several studies have shown that reference values of platelet count in fetuses reach adult values early in gestation, it is unlikely that this correlation is confounded by gestational age.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Thrombocytopenia is a common finding in small for gestational age (SGA) neonates and is thought to result from a unique pathophysiologic mechanism related to chronic intrauterine hypoxia. Our objective was to estimate the incidence and severity of early-onset thrombocytopenia in SGA neonates, and to identify risk factors for thrombocytopenia. We performed a retrospective cohort study of all consecutive SGA neonates admitted to our ward and a control group of appropriate for gestational age (AGA) neonates matched for gestational age at birth. Main outcome measures were incidence and severity of thrombocytopenia, hematological and clinical risk factors for thrombocytopenia, and bleeding. A total of 330 SGA and 330 AGA neonates were included, with a mean gestational age at birth of 32.9 ± 4 weeks. Thrombocytopenia (<150x109/L) was found in 53% (176/329) of SGA neonates and 20% (66/330) of AGA neonates (relative risk (RR) 2.7, 95% confidence interval (CI) [2.1, 3.4]). Severe thrombocytopenia (21-50x109/L) occurred in 25 neonates (8%) in the SGA and 2 neonates (1%) in the AGA group (RR 12.5, 95% CI [3.0, 52.5]). Platelet counts <20x109/L were not recorded. Within the SGA group, lower gestational age at birth (p = <0.01) and erythroblastosis (p<0.01) were independently associated with a decrease in platelet count. Platelet count was positively correlated with birth weight centiles. In conclusion, early-onset thrombocytopenia is present in over 50% of SGA neonates and occurs 2.7 times as often as in AGA neonates. Thrombocytopenia is seldom severe and is independently associated with lower gestational age at birth and erythroblastosis.

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Thrombopoiesis in small for gestational age newborns

Cited by 21 publications

References 23 publications

Perinatal factors affecting platelet parameters in late preterm and term neonates

Perinatal factors affecting platelet parameters in late preterm and term neonates

Thrombocytopenia in Small-for-Gestational-Age Infants

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

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