Study of risk factors of neonatal thrombocytopenia

Abstract

Background: Neonatal thrombocytopenia (platelet count < 1.5 lac/µl) is the commonest haematological abnormality encountered in neonatal intensive care unit (NICU). Thrombocytopenia if not detected can result in devastating complications. Determining the risk factors of thrombocytopenia enables us to prevent the inevitable and irreversible complications. The present study highlights the pattern, severity and risk factors of neonatal thrombocytopenia in our hospital.Methods: Prospective observational study was conducted on 200 neonates with thrombocytopenia admitted in NICU of our hospital. Maternal and neonatal risk factors were recorded. Neonates were grouped based on the severity of thrombocytopenia. The risk factors were compared with severity of thrombocytopenia.Results: 200 neonates with thrombocytopenia were divided into three groups based on severity of thrombocytopenia. 81% of babies had moderate to severe thrombocytopenia. The most common maternal predisposing factors were pregnancy induced hypertension (PIH), premature rupture of membranes (PROM) and anemia.62.5% babies were low birth weight babies and they had severe thrombocytopenia. 56% babies had late onset neonatal thrombocytopenia and 44% had early onset thrombocytopenia. The most common neonatal risk factors were sepsis in 48.5% babies and birth asphyxia in 20% babies.Conclusions: The severity of neonatal thrombocytopenia in our NICU was moderate to severe type. PIH, PROM and anemia were the commonest maternal risk factors. Preterm and low birth weight babies had severe thrombocytopenia. Sepsis and birth asphyxia were the commonest neonatal risk factors. Birth asphyxia was associated with early onset neonatal thrombocytopenia and sepsis was associated with late onset thrombocytopenia. Severe thrombocytopenia can be used as a prognostic indicator in sick neonates.

Severity of thrombocytopenia and its outcome in preterm and term neonates admitted in neonatal intensive care unit in a rural tertiary care hospital

“…This finding was comparable with the study done by Keerthi Tirupathi who found that 5% of the babies were associated with Meconium aspiration syndrome. 9 In the present study, out of 60 babies admitted with thrombocytopenia, Necrotising enterocolitis was seen in 5% cases. This finding was comparable with the studies done by Ramesh Babu, Lea Bonifacio, and Basil M Hanoudi, who found NEC in 4%,7%, and 4.21% respectively.…”

“…8 Keerthi tirupathi et al, (N=200) studied about the risk factors of neonatal thrombocytopenia in 2016 at Maharashtra. 9 Ramesh babu et al, (N=100) conducted a study on the clinical profile of neonates with thrombocytopenia in 2014 at Dharmapuri. 10 Lea bonifacio et al, studied thrombocytopenia related outcome in 94 neonates in 2006 at New Jersey.…”

“…The prevalence of moderate and severe thrombocytopenia in present study was comparable with the study done by S. Patil et al, and Rameshbabu et al 5,10 In a study done by Anubha Sharma et al, and Keerthi Tirupathi et al, study and Lea bonifacio et al, study there was more number of babies with thrombocytopenia in moderate and severe group. 8,9,11 The higher prevalence of severe thrombocytopenia is probably due to higher proportion of septicemic neonates in NICU admissions.…”

“…This finding was comparable with the studies of Ramesh Babu (25%), Keerthi Tirupathi (20%), Basil M Haoudi (28.4%). 10,9,12 Perinatal asphyxia is reported, widely, to be associated with neonatal thrombocytopenia. Perinatal asphyxia was diagnosed based on the following conditions in present study; an arterial pH of 7.34, neonatal neurological manifestation suggestive of HIE, evidence of multiorgan dysfunction.…”

Phototherapy in full term neonates suffering from unconjugated hyperbilirubinemia; Does it affect platelet count?

“…The kernicterus manifests as devastating permanent brain injury leading eventually to permanent brain retardation. [3][4][5] The NH occurs because of imbalance of liver functioning due to immaturity and increased bilirubin load to detoxify. This results in lagging behind of bilirubin in capillaries giving an appearance of yellowness (jaundice).…”