Using Platelet Parameters to Anticipate Morbidity and Mortality Among Preterm Neonates: A Retrospective Study

Go, Hayato; Ohto, Hitoshi; Nollet, Kenneth E.; Takano, Shizuko; Kashiwabara, Nozomi; Chishiki, Mina; Maeda, Hitoshi; Imamura, Takashi; Kawasaki, Yukihiko; Momoi, Nobuo

doi:10.3389/fped.2020.00090

Cited by 26 publications

(23 citation statements)

References 36 publications

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“…This study showed that platelet counts are significantly lower in infants developing BPD and in rats with experimental BPD induced by hyperoxia. This finding is in line with a study by Okur et al who reported a lower PLT and PMI in BPD infants during the first week of life (15), but is not supported by Go et al who report that platelet parameters at birth were not associated with BPD after multivariate analysis (16). This difference might be due to the different timing of these studies.…”

Section: Discussionsupporting

confidence: 87%

Close Association Between Platelet Biogenesis and Alveolarization of the Developing Lung

et al. 2021

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Bronchopulmonary dysplasia (BPD) is a neonatal chronic lung disease characterized by an arrest in alveolar and vascular development. BPD is secondary to lung immaturity, ventilator-induced lung injury, and exposure to hyperoxia in extremely premature infants, leading to a lifelong impairment of lung function. Recent studies indicate that the lung plays an important role in platelet biogenesis. However, the dynamic change of platelet production during lung development and BPD pathogenesis remains to be elucidated. We investigated the dynamic change of platelet parameters in extremely premature infants during BPD development, and in newborn rats during their normal development from birth to adulthood. We further studied the effect of hyperoxia exposure on platelet production and concomitant pulmonary maldevelopment in an experimental BPD rat model induced by prolonged exposure to hyperoxia. We detected a physiological increase in platelet count from birth to 36 weeks postmenstrual age in extremely premature infants, but platelet counts in extremely premature infants who developed BPD were persistently lower than gestational age-matched controls. In line with clinical findings, exposure to hyperoxia significantly decreased the platelet count in neonatal rats. Lung morphometry analysis demonstrated that platelet counts stabilized with the completion of lung alveolarization in rats. Our findings indicate a close association between platelet biogenesis and alveolarization in the developing lung. This phenomenon might explain the reduced platelet count in extremely premature infants with BPD.

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Section: Discussionsupporting

confidence: 87%

Close Association Between Platelet Biogenesis and Alveolarization of the Developing Lung

et al. 2021

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“…Since large platelets are more reactive than small platelets, an elevated platelet size (i.e., a high MPV) is considered a marker of platelet activation ( 56 , 57 ). Elevated MPV has been associated with cardiovascular disease in adults ( 58 ) and several studies have analyzed the association between MPV and complications of prematurity such as bronchopulmonary dysplasia, sepsis, intraventricular hemorrhage, retinopathy of prematurity, or PDA ( 59 – 63 ). Nevertheless, our meta-analysis could not demonstrate an association between MPV and hsPDA ( Figure 4 ).…”

Section: Discussionmentioning

confidence: 99%

Platelet Counts and Patent Ductus Arteriosus in Preterm Infants: An Updated Systematic Review and Meta-Analysis

González-Luis

Ghiradello

Bas-Suárez³

et al. 2021

Front. Pediatr.

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Background: A meta-analysis published in 2015 showed a significant association between low platelet counts in the first day(s) of life and risk of patent ductus arteriosus (PDA). The meta-analysis pooled data from 11 studies cohorts (3,479 preterm infants).Objective: To update the meta-analysis by adding new studies on the topic and including other platelet parameters different from platelet counts.Methods: PubMed/Medline and Embase databases were searched. Random-effects risk ratios (RR) and differences in means (DM) and 95% confidence intervals (CI) were calculated.Results: We included 31 studies (7,638 infants). Meta-analysis showed that the risk of developing any PDA was significantly associated with platelet counts<150 × 109/L (11 studies, RR 1.58, 95% CI 1.28 to 1.95), and <100 x 109/L (7 studies, RR 1.61, 95% CI 1.14 to 2.28), but not <50 x 109/L (4 studies, RR 1.34, 95% CI 0.77 to 2.32). Risk of developing hemodynamically significant PDA (hsPDA) was significantly associated with platelet counts<150 x 109/L (12 studies, RR 1.33, 95% CI 1.09 to 1.63), and <100 x 109/L (7 studies, RR 1.39, 95% CI 1.06 to 1.82), but not <50 x 109/L (6 studies, RR 1.24, 95% CI 0.86 to 1.79). Infants with hsPDA had significantly lower mean platelet counts (19 studies, DM 22.0 x 109, 95% CI 14.9 to 29.1) and platelet mass (11 studies, DM 214.4, 95% CI 131.2 to 297.5) and significantly higher platelet distribution width (PDW, 9 studies, DM −0.53, 95% CI −1.01 to −0.05) than infants without hsPDA. Meta-analysis could not demonstrate significant differences in mean platelet volume (MPV).Conclusion: Compared to the previous analysis, this updated meta-analysis included 21 additional studies that provide stronger evidence of the association between low platelet counts and PDA/hsPDA. Other platelet parameters such as platelet mass and PDW are also associated with hsPDA risk. However, the low number of platelets may be an epiphenomenon associated with the maturity and clinical stability of preterm infants rather than a contributing factor in the pathogenesis of PDA.

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“…However, a few studies have focused on the relationship between MPV and the mortality of neonatal, especially premature neonates. Go et al [ 24 ] found that MPV ≥10.2 fL correlates with mortality among neonates born after <32 weeks’ gestation. Hebatallah [ 25 ] found that day 3 MPV can be used as a surrogate marker for the prediction of early-onset sepsis and associated mortality in preterm neonates.…”

Section: Discussionmentioning

confidence: 99%

Mean platelet volume and red blood cell distribution width is associated with prognosis in premature neonates with sepsis

et al. 2021

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Objective To evaluate the prognostic value of the mean platelet volume (MPV) and red blood cell distribution width (RDW) in sepsis among premature neonates. Methods This was a retrospective cohort study conducted in the neonatal intensive care unit between May 2015 and May 2020. Premature neonates with late-onset sepsis were enrolled. The demographic data, blood cell count analysis, C-reactive protein, and blood culture were compared between survivors and non-survivors. Results A total of 73 premature neonates with sepsis in the survivor group and 10 cases in the non-survivor group. Significant differences were observed between the survivor and non-survivor groups with regard to birth weight, MPV, and RDW (P < 0.05). The results of binomial stepwise logistic regression suggested that MPV (OR = 3.226, P = 0.017 < 0.05) and RDW (OR = 2.058, P = 0.019 < 0.05) were independent predictor for prognosis in preterm with sepsis. A receiver operating characteristic analysis showed that the areas under the curves were 0.738 for MPV alone, 0.768 for RDW alone, and 0.854 for MPV combined with RDW. Conclusion MPV and RDW were independent predictors of prognosis and the combination of the two helps in predicting the prognosis of preterm with late-onset sepsis in the early stage.

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Using Platelet Parameters to Anticipate Morbidity and Mortality Among Preterm Neonates: A Retrospective Study

Cited by 26 publications

References 36 publications

Close Association Between Platelet Biogenesis and Alveolarization of the Developing Lung

Close Association Between Platelet Biogenesis and Alveolarization of the Developing Lung

Platelet Counts and Patent Ductus Arteriosus in Preterm Infants: An Updated Systematic Review and Meta-Analysis

Mean platelet volume and red blood cell distribution width is associated with prognosis in premature neonates with sepsis

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