Thrombocytopenia in the First 24 Hours After Birth and Incidence of Patent Ductus Arteriosus

Abstract

Thrombocytopenia in the first 24 hours after birth was not associated with PDA in this largest VLBW/ELBW infant cohort studied to date. Impaired platelet function, due to immaturity and critical illness, rather than platelet number, might play a role in ductus arteriosus patency.

Platelet Counts in the First Seven Days of Life and Patent Ductus Arteriosus in Preterm Very Low-Birth-Weight Infants

“…Whether this is also the case in human infants remains controversial [8,9,10,11,12]. Our data show that in a cohort of preterm VLBW infants the median platelet count nadir and the rate of mild, moderate or severe thrombocytopenia - within the first 2 days of life - were not significantly associated with the presence of HSPDA on day 3.…”

“…Second, we observed in our cohort a relatively high rate of HSPDA (54.1%). Nevertheless, this is still within the wide range (30-70%) of rates reported in the other cohorts [7,8,9,10,11,12,13]. Third, the rate of thrombocytopenia in the more stable patients could be underestimated as the platelet counts were done at the discretion of the healthcare providers and not at a fixed interval.…”

“…By contrast, platelet counts in the first 1-3 days of life were not related to failure of pharmacological PDA treatment in the cohorts of Alyamac Dizdar et al [8], Dani et al [9] and Sallmon et al [12]. However, low platelet counts beyond day 3 may influence the pharmacological closure of the DA with COX inhibitors.…”

“…Finally, the largest published study evaluating the relationship between platelets and PDA examined a retrospective cohort of 1,350 VLBW infants (497 infants <1,000 g). This study found that mild, moderate or severe thrombocytopenia in the first day of life was not associated with a higher incidence of PDA [12]. …”

“…In a logistic regression model, a platelet count ≤150 × 10 9 /l was identified as an independent predictor of hemodynamically significant PDA (HSPDA). Several investigators [8,9] have confirmed the findings of Echtler et al [7], whereas others produced discordant observations which do not suggest that early thrombocytopenia consistently results in HSPDA [10,11,12,13]. Additional series of patients are required to resolve this controversy.…”