Effect of gestational age, prematurity and birth asphyxia on platelet indices in neonates

Kannar, Vidyavathi; Deepthi, Anusha; Kumar, M L Harendra; Junjegowda, Krishnappa; Mariyappa, Narayanaswamy

doi:10.4103/2249-4847.140399

Cited by 9 publications

(16 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several investigators proposed that it is not the number of platelets but other quantitative or qualitative platelet parameters that are associated with a greater risk of developing PDA. 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 ).…”

Section: Discussionmentioning

confidence: 99%

“…As mentioned above, large platelets are considered to be metabolically and enzymatically more active than small platelets. PDW reflects the variability in the platelet size and its increase is considered as a sign of platelet activation ( 56 , 57 ). According to the hypothesis of the role of platelets in DA closure, a higher degree of platelet activation, and therefore a higher PDW, would be expected in the infants without PDA.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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.

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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.

View full text Add to dashboard Cite

show abstract

Section: Postnatal and Neonatal Factors Associated With Platelet Dysfmentioning

confidence: 53%

“…Term newborns who were small for gestational age tended to have lower platelet counts but higher mean platelet volumes (MPVs) [113,114]. A similar pattern was also observed in asphyxiated term newborns [113]. MPV is a measure of average platelet size [115] and may serve as a marker of platelet production, consumption, or severity of some disorder of bone marrow, thrombosis, or infection [116,117].…”

Section: Postnatal and Neonatal Factors Associated With Platelet Dysfmentioning

confidence: 90%

“…Nitric oxide • Abnormal thromboelastogram values [109] • Prolonged prothrombin time [109] • Prolonged bleeding time [111] Therapeutic hypothermia • Abnormal thromboelastogram values, associated with bleeding [199] • Reduced platelet count [123,200] • Prolonged bleeding time and PFA 100 closure time [201] Asphyxia and RDS • Reduced platelet count [113,118,120] • High MPV and PDW [113,117] • Increased thrombopoietin level [118] • Increased thromboxane level [120] Mechanical ventilation • Reduced platelet count [121] Extracorporeal membrane oxygenation (ECMO)…”

Section: Neonatal Factormentioning

confidence: 99%

See 1 more Smart Citation

Platelets in the Newborn

Esiaba¹,

Mousselli²,

Faison³

et al. 2019

Neonatal Medicine

View full text Add to dashboard Cite

Platelets were first described in the mid-nineteenth century. Since then, their roles were identified in hemostasis and thrombosis, inflammation, leukocyte interactions, angiogenesis, and cancer growth. But there is little information about such platelet functions in the newborn. Several studies highlighted some platelet differences between newborns and adults. Yet, in spite of these differences, healthy newborns appear to be adequately protected. A number of factors, however, were reported to negatively affect neonatal platelets. These include maternal hypertensive disorders or infections, neonatal asphyxia or respiratory distress, therapies such as ampicillin or indomethacin, and treatment modalities such as ventilators, nitric oxide, or extracorporeal membrane oxygenation (ECMO). Their effects on newborn platelets are usually transitory, lasting from several hours to a few days or weeks. If these effects are well characterized, they could serve as reporters for diagnosis and monitoring during therapy. Careful studies of neonatal platelets are needed to improve the understanding of basic physiology and pathophysiology in this cohort and to identify possible targets for intervention and therapy.

show abstract

Platelet Indices: Universally Available Clinical Adjunct for Diagnosing Necrotizing Enterocolitis

et al. 2023

View full text Add to dashboard Cite

Platelet function parameters can be predictive of several adult diseases and their severity. However, few studies report on the association between platelet indices and neonatal diseases, specifically necrotizing enterocolitis (NEC). Objective: To investigate whether platelet indices are associated with NEC diagnosis and NEC-related mortality. Methods: We retrospectively examined records from infants admitted to the neonatal intensive care unit with a diagnosis of NEC, verified by the presence of pneumatosis on x-ray or pathology at surgery. We compared them to an age matched group of prematures without NEC. We investigated platelet count, mean platelet volume (MPV), platelet distribution width (PDW) and red cell distribution width to platelet ratio (RPR) and delta platelets from birth to the time of NEC diagnosis or day of life (DOL) 14 in the control group. Results: Sixty-nine infants with NEC and 78 control infants were studied. Basic sociodemographic data were similar in both groups. All platelet parameters measured –except for MPV- were significantly associated with NEC diagnosis. Although MPV was not associated with the diagnosis of NEC (p=0.800), it was significantly associated with NEC related mortality (p<0.001). Only total platelet count and RPR were significantly associated with both NEC diagnosis (p<0.0001) and mortality (p=0.04 and 0.01 respectively). On multivariable analysis only the change in platelet count from birth to time of diagnosis remained significant. Conclusion: While not definitive, this study demonstrates that routinely available, inexpensive and easily calculated platelet indices can offer a clinical adjunct in the often elusive attempts to diagnose NEC in preterm neonates.

show abstract

Effect of gestational age, prematurity and birth asphyxia on platelet indices in neonates

Cited by 9 publications

References 0 publications

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

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

Platelets in the Newborn

Platelet Indices: Universally Available Clinical Adjunct for Diagnosing Necrotizing Enterocolitis

Contact Info

Product

Resources

About