Risk Factors and Outcome of Neonatal Thrombocytopenia
Introduction: About 30% of neonates develop thrombocytopenia during hospital admission. Inevitable and irreversible complications can be prevented by determining the risk factors of neonatal thrombocytopenia. The present study was undertaken to determine the risk factors and outcome of neonatal thrombocytopenia in neonates admitted to Neonatal Intensive Care Unit Benazir Bhutto Hospital Rawalpindi.
Materials and Methods: A prospective study was conducted to evaluate the risk factors for neonatal thrombocytopenia (NT) in 160 neonates. Neonatal and maternal risk factors were recorded and neonates were categorized into three groups based on the severity of thrombocytopenia.
Results: A higher percentage of the neonates 89 (55.6%) were male. The majority (61.9%) had moderate neonatal thrombocytopenia while 21.9% had severe neonatal thrombocytopenia. A highly significant difference was observed for the distribution of gestational age, platelet count, birth weight, and age at admission (for all p-value ≥0.0001) among different groups. Multivariate logistic regression revealed a significant independent association of prematurity, birth asphyxia, and low birth weight with neonatal thrombocytopenia.
Conclusion: Prematurity, low birth weight, and birth asphyxia were the significant causes of Neonatal thrombocytopenia. The mortality rate increased significantly with the severity of thrombocytopenia.
2. Kilby MD, Johnson A, Oepkes D, editors. Fetal Therapy: Scientific Basis and Critical Appraisal of Clinical Benefits. Cambridge University Press; 2019 Nov 30.
3. Wiedmeier SE, Henry E, Sola-Visner MC, Christensen RD. Platelet reference ranges for neonates, defined using data from over 47 000 patients in a multihospital healthcare system. Journal of perinatology. 2009; 29(2):130-134.
4. Resch E, Hinkas O, Urlesberger B, Resch B. Neonatal thrombocytopenia—causes and outcomes following platelet transfusions. European journal of pediatrics. 2018;177(7):1045-1052.
5. Sola MC, Del Vecchio A, Rimsza LM. Evaluation and treatment of thrombocytopenia in the neonatal intensive care unit. Clinics in perinatology. 2000; 27(3):655-679.
6. Roberts I, Murray NA. Neonatal thrombocytopenia: causes and management. Archives of Disease in Childhood-Fetal and Neonatal Edition.2003; 88(5): F359-364.
7. Tsao PN, Teng RJ, Chou HC, Tsou KI. The thrombopoietin level in the cord blood in premature infants born to mothers with pregnancy-induced hypertension. Neonatology. 2002; 82(4):217-21.
8. Bhat YR, Cherian CS. Neonatal thrombocytopenia associated with maternal pregnancy-induced hypertension. The Indian Journal of Pediatrics. 2008; 75(6):571-573.
9. Pritchard JA, Cunningham FG, Pritchard SA, Mason RA. How often does maternal preeclampsia-eclampsia incite thrombocytopenia in the fetus? Obstetrics and gynecology. 198; 69(3 Pt 1):292-295.
10. Fernandez CJ. Causes of neonatal thrombocytopenia.UpToDate® 2017Nov 28.
11. Ulusoy E, Tüfekçi Ö, Duman N, Kumral A, İrken G, Ören H. Thrombocytopenia in neonates: causes and outcomes. Annals of hematology. 2013; 92(7):961-967.
12. Gunnink SF, Vlug R, Fijnvandraat K, Van Der Bom JG, Stanworth SJ, Lopriore E. Neonatal thrombocytopenia: etiology, management and outcome. Expert review of hematology. 2014; 7(3):387-395.
13. American College of Obstetricians and Gynecologists (ACOG) Neonatal encephalopathy and cerebral palsy: executive summary. Obstet Gynecol 2004; 103:780–781
14. Tirupathi K, Swarnkar K, Vagha J. Study of risk factors of neonatal thrombocytopenia. Int J Contemp Pediatr. 2017; 1:191-196.
15. Von Lindern JS, van den Bruele T, Lopriore E, Walther FJ. Thrombocytopenia in neonates and the risk of intraventricular hemorrhage: a retrospective cohort study. BMC pediatrics. 2011; 11(1):16-23
16. Khalessi N, Khosravi N, Sanni S. The prevalence and risk factors for neonatal thrombocytopenia among newborns admitted to intensive care unit of Aliasghar children’s hospital. Iranian J Blood Cancer. 2013;5(2):41-45.
17. Gupta A, Mathai SS, Kanitkar M. Incidence of thrombocytopenia in neonatal intensive care unit. Med J Armed Forces India. 2011;67(3):234-236.
18. Bagale BB, Bhandari A. Neonatal Thrombocytopenia: Its associated risk factors and outcome in NICU in a tertiary hospital in Nepal. Journal of College of Medical Sciences-Nepal. 2018 30; 14(2):65-68.
19. Jeremiah ZA, Oburu JE, Ruggeri M. Pattern and prevalence of neonatal thrombocytopenia in Port Harcourt, Nigeria. Pathol Lab Med Int. 2010;2:27-31.
20. Eslami Z, Lookzadeh MH, Noorishadkam M, Hashemi A, Ghilian R, PirDehghan A. Thrombocytopenia and Associated Factors in Neonates Admitted to NICU during Years 2010_2011. Iranian journal of pediatric hematology and oncology. 2013; 3(1):205-215.
21. Nandyal SS, Shashikala P, Sahgal V. Study of thrombocytopenia in neonatal intensive care unit. Indian J Pathol Oncol. 2016; 3(1):55-59.
22. Hanoudi BM. Study of risk factors for neonatal thrombocytopenia in preterm infants. Mustansiriya Med J. 2015; 14(1):64-9.
23. Christensen RD, Henry E, Wiedmeier SE, Stoddard RA, Sola-Visner MC, Lambert DK, Kiehn TI, Ainsworth S. Thrombocytopenia among extremely low birth weight neonates:data from a multihospital healthcare system. J Perinatol. 2006; 26:348–353.
24. Patil S, Mangshetty R, Patil B. Outcome of neonates with thrombocytopenia. Journal of Evolution of Medical and Dental Sciences. 2014;3(17):4533-4537.
25. Baer VL, Lambert DK, Henry E, Christensen RD. Severe thrombocytopenia in the NICU. Pediatrics. 2009; 124(6):e1095-100.
26. Bonifacio L, Petrova A, Nanjundaswamy S, Mehta R. Thrombocytopenia related neonatal outcome in preterms. The Indian Journal of Pediatrics. 2007; 74(3):269-274.
27. Roberts I, Murray NA. Neonatal thrombocytopenia. SeminFetal Neonatal Med 2008; 13:256–264.
28. Roberts, I., Stanworth, S. and Murray, N.A., 2008. Thrombocytopenia in the neonate. Blood reviews, 22(4), pp.173-186.
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