Thrombocytopenia in neonates with polycythemia: incidence, risk factors and clinical outcome

Vlug, R. D.; Lopriore, Enrico; Janssen, Marleen; Middeldorp, Johanna M.; Rath, Mirjam E.A.; Smits-Wintjens, Vivianne E.H.J.

doi:10.1586/17474086.2015.997705

Cited by 18 publications

(17 citation statements)

References 19 publications

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“…Platelet count <100,000/μL has been found in 4.5% of infants with HCT 0.65-0.69 L/L and in 19% with HCT 0.70-0.80 L/L (Morag et al 2011). Platelet count <50,000/μL was found mainly in infants with HCT !0.70 L/L, but was also independently associated with intrauterine growth restriction (Vlug et al 2015). Thrombocytopenia in polycythemic patients may have several causes:…”

Section: Central Nervous Systemmentioning

confidence: 95%

Polycythemia and Hyperviscosity in Neonates

Linderkamp¹

2016

Neonatology

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Polycythemia and the resulting increase in blood viscosity are common in the neonatal period. However, neonatal blood has several favorable properties including lower plasma viscosity, RBC aggregation, and increased red blood cell deformability compared with adults. Oxygen transport to vital organs is, therefore, usually not compromised when the hematocrit (HCL) is below 0.70 L/L. Polycythemia may develop before (increased erythropoiesis, prenatal transfusion syndromes) or after birth (late cord-clamping). Nevertheless, delayed or late cord-clamping should be encouraged because of favorable circulatory effectsamong other advantages. Signs of polycythemia often result from the underlying disorder (e.g., intrauterine asphyxia, maternal diabetes) rather than from the increased HCT and blood viscosity. Postnatal blood volume loss contributes to the development of polycythemia in most affected infants. Early oral feeding or, if necessary, additional i.v. fluid is therefore the first-line treatment and prophylaxis against polycythemia. Because partial exchange transfusion (PET) did not improve the long-term neurodevelopmental outcome and even increased the risk of early complications (necrotizing enterocolitis, septicemia) in polycythemic infants, indications for PET should respiratory distress requiring oxygen) with HCT !0.70 L/L. • PET should be done with normal saline.

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Section: Central Nervous Systemmentioning

confidence: 95%

Polycythemia and Hyperviscosity in Neonates

Linderkamp¹

2016

Neonatology

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“…The hematological disorders might increase susceptibility to early-onset infections (EOI) (10) and bleeding disorders, such as intraventricular hemorrhage (IVH) and pulmonal hemorrhage (PH), particularly in very preterm infants. Concerning major bleedings, it is discussed that plasmatic coagulation disorders could be a bigger issue than thrombocytopenia (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Aberrant Hematopoiesis and Morbidity in Extremely Preterm Infants With Intrauterine Growth Restriction

et al. 2021

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Background and Objective: Intrauterine growth restriction (IUGR) poses additional challenges in extremely low gestational age newborns (ELGANs). We assessed disturbed hematopoiesis and morbidities associated with this disorder.Methods: This single-center retrospective case–control study compared perinatal hematological profiles, major morbidities, and mortality of 49 infants (gestational age <28 weeks, birth weight ≤ 3rd percentile, and compromised placental function) and 98 infants (birth weight >10th percentile) matched for gestational age, year, and sex.Results: IUGR-ELGANs had significantly elevated nucleated red blood cells and lower neutrophil and platelet counts at birth and on the third day of life. During the first week of life, IUGR-ELGANs received more red blood cell, platelet, and plasma transfusions and were more intensively treated with antibiotics. Rates of infections acquired during the first week (59.2 vs. 17.3%, p < 0.001), severe bronchopulmonary dysplasia or death (42.9 vs. 17.3%, p < 0.01), and mortality (36.7 vs. 7.1%, p < 0.001) were markedly elevated in IUGR-ELGANs, but not of hemorrhages or other morbidities.Conclusions: IUGR-ELGANs have high rates of acquired infections during the first week of life and display severe pulmonary morbidity leading to bronchopulmonary dysplasia or death. The high rate of transfusions observed in these infants warrants further scrutiny.

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“…The increase in hematocrit in the neonate is due to three mechanisms: response to hypoxia, blood transfusions, and hemoconcentration due to decreased plasma volume [3][4][5]. Associated factors can be either maternal or neonatal factors.…”

Section: Introducctionmentioning

confidence: 99%

Prevalencia de Policitemia Neonatal y Factores Asociados en Recién Nacidos

Barros

Gavilanes

Barros

2021

REV-SEP

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Introducción: La policitemia afecta del 1 a 5% de los recién nacidos, se asocia a complicaciones por afectación orgánica y sistémica en el neonato que puede ser prevenible. El objetivo de la presente investigación fue determinar la prevalencia de Policitemia neonatal y sus factores asociados en recién nacidos en el servicio de maternidad del Hospital ¨Vicente Corral Moscoso de la ciudad de Cuenca-Ecuador en el período mayo 2018 a mayo 2019. Métodos: Se realizó un estudio transversal analítico, el universo estuvo conformado por todos los recién nacidos en el servicio de maternidad del Hospital ¨Vicente Corral Moscoso¨. La muestra fue probabilística de 470 neonatos y sus madres. Para identificar asociación se realizó mediante X2 y para medir intensidad de asociación se utilizó OR (IC 95%) y valor de P < 0.05. Resultados: Ingresaron al estudio en forma aleatoria 470 casos. Se obtuvo una prevalencia del 12.8%. La residencia materna del 93% fue por sobre los 2000 metros sobre el nivel del mar. Los factores asociados fueron: bajo peso al nacer (OR 3.8; IC95%: 1.9 – 7.5) P < 0.001), patología materna incluida la diabetes (OR 2.6, IC95%: 1.3 – 5.2) P = 0.013), toxemia del embarazo (OR 2.3; IC95%: 0.7 – 7.6) P = 0.134 y asociación negativa con prematuridad (OR 0.3; IC 95%: 0.07 – 1.2) P = 0.099. Conclusiones: la prevalencia de policitemia neonatal es alta y se asocia significativamente con bajo peso al nacer, patología materna.

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Thrombocytopenia in neonates with polycythemia: incidence, risk factors and clinical outcome

Abstract: Thrombocytopenia occurs in 51% of neonates with polycythemia and is independently associated with growth restriction. Increased hematocrit is associated with decreased platelet count.

Cited by 18 publications

References 19 publications

Polycythemia and Hyperviscosity in Neonates

Polycythemia and Hyperviscosity in Neonates

Aberrant Hematopoiesis and Morbidity in Extremely Preterm Infants With Intrauterine Growth Restriction

Prevalencia de Policitemia Neonatal y Factores Asociados en Recién Nacidos

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