Frequency and Outcome of Thrombocytopenia in Neonates who are at Risk of Developing
Thrombocytopenia - A Prospective-Observational Study
Department of Neonatology, BSMMU, Dhaka, India
*Corresponding Author: Saha, Department of Neonatology, BSMMU, Dhaka, India.
June 13, 2023; Published: February 28, 2023
Thrombocytopenia is the commonest hematological abnormality encountered in the neonatal intensive care unit (NICU). Thrombocytopenia is more common in certain risk group. This prospective– observational study was conducted among 78 consecutive at risk neonates admitted in NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU). Platelet count was done in all at risk neonates at enrollment and less than 1,50,000/cu mm was taken as the cut off point for determining thrombocytopenia. If initial platelet count was low then platelet count was done every alternate day till discharge or normal. If initial platelet count revealed normal, then babies were followed up clinically whether they develop any further risk condition for developing thrombocytopenia. During the period from enrollment to discharge, if any baby develops thrombocytopenia at any time then baby was defined as thrombocytopenic. Among 78 pts, initial platelet count was low in 8 patients (10.2%) and in 29 (37.1%) pts subsequently developed risk factor and platelet count was done in those patients. Among them, 23 patients revealed thrombocytopenia. Overall 31 (39.7%) patients found thrombocytopenic among 78 at risk neonates. Pregnancy induced hypertension (PIH), neonatal sepsis, small for gestational age (SGA) and intra uterine growth restriction (IUGR), prematurity, Necrotizing Enterocolitis (NEC) were significantly associated with thrombocytopenia (p = <0.05). Sepsis and NEC were found to be independent risk factor for thrombocytopenia. Regarding outcome, length of hospital stay was significantly more in thrombocytopenic patients than non-thrombocytopenic patients (p = <0.037). Death rate was also higher in thrombocytopenic patients in comparison to non- thrombocytopenic patients (p value- 0. 007).
Keywords: Frequency; Thrombocytopenia; Neonates; Observational Study
- Roberts I and Murray NA. “Neonatal thrombocytopenia: causes and management”. Archives of Disease in Childhood-Fetal and Neonatal Edition5 (2003): F359-364.
- Veneri D., et al. “Thrombocytopenias: a clinical point of view”. Blood Transfusion2 (2009): 75.
- Roberts IA and Murray NA. “Neonatal thrombocytopenia: new insights into pathogenesis and implications for clinical management”. Current Opinion in Pediatrics 1 (2001): 16-21.
- Gomella TL., et al. “Neonatology management, procedure, on-call problems, disease and drugs”. Seventhedn. McGraw Hill education, Lange (2013).
- Gupta A., et al. “Incidence of thrombocytopenia in the neonatal intensive care unit”. Medical Journal Armed Forces India3 (2011): 234-236.
- Eslami Z., et al. “Thrombocytopenia and associated factors in neonates admitted to NICU during years 2010-2011”. Iranian Journal of Pediatric Hematology and Oncology1 (2013): 205.
- Murray NA., et al. “Platelet transfusion in the management of severe in intensive care unit patients”. Transfusion Medicine1 (2002): 35-41.
- Rennie MJ. “Rennie and Roberton’s Textbook of Neonatology”. 5th Churchill Livingstone, Elsevier (2012): 777.
- Holzhauer S and Zieger B. “Diagnosis and management of neonatal thrombocytopenia”. Seminars in Fetal and Neonatal Medicine 6 (2011): 305-310.
- Sharma A and Thapar K. “A prospective observational study of thrombocytopenia in high-risk neonates in a tertiary care teaching hospital”. Sri Lanka Journal of Child Health4 (2015).
- Sonam S., et al. “Study of thrombocytopenia in neonatal intensive care unit”. Indian Journal of Pathology and Oncology1 (2013): 55-59.
- Sanii S., et al. “The prevalence and risk factors for neonatal thrombocytopenia among newborns admitted to intensive care unit of Aliasghar children’s hospital”. Iranian Journal Blood Cancer 2 (2013): 41-45.
- Charoo BA., et al. “Nosocomial sepsis-induced late onset thrombocytopenia in a neonatal tertiary care unit: a prospective study”. Hematology/Oncology and Stem Cell Therapy 2 (2009): 349-353.
- Gupta AK., et al. “Neonatal thrombocytopenia and platelet transfusion”. Asian Journal of Transfusion Science 6.2 (2012): 161-164.
- Patil S., et al. “Outcome of neonates with thrombocytopenia”. Journal of Evolution of Medical and Dental Sciences17 (2014): 4533-4539.
- Jeremiah ZA and Oburu JE. “Pattern and prevalence of neonatal thrombocytopenia in Port Harcourt, Nigeria”. Pathology and Laboratory Medicine International 2 (2010): 27-31.
- Arif SH., et al. “Thrombocytopenia and bacterial sepsis in neonates”. Indian Journal of Hematology and Blood Transfusion3 (2012): 147-150.
- Maruyama H., et al. “Thrombocytopenia in preterm infants with intrauterine growth restriction”. Actamedica Okayama5 (2008): 313-317.
- Nursen B., et al. “Perinatal asphyxia and thrombocytopenia”. Ondokuzmayıs Tıp Dergisi 2 (1999): 100-105.
- Bonifacio L., et al. “Thrombocytopenia related neonatal outcome in preterms”. The Indian Journal of Pediatrics 3 (2007): 269-274.
- Von Lindern JS., et al. “Thrombocytopenia in neonates and the risk of intraventricular hemorrhage: a retrospective cohort study”. BMC Pediatrics 1 (2011): 1-7.
- Sola MC., et al. “Evaluation and treatment of thrombocytopenia in the neonatal intensive care unit”. Clinics in Perinatology 3 (2000): 655-679.