Study of risk factors of neonatal thrombocytopenia

Authors

  • Keerthi Tirupathi Department of Pediatrics, Acharya Vinobha Bhave Rural Hospital, Jawaharlal Nehru Medical College, Datta Meghe institute of medical sciences, Sawangi, Wardha, Maharashtra, India
  • Keerti Swarnkar Department of Pediatrics, Acharya Vinobha Bhave Rural Hospital, Jawaharlal Nehru Medical College, Datta Meghe institute of medical sciences, Sawangi, Wardha, Maharashtra, India
  • Jayant Vagha Department of Pediatrics, Acharya Vinobha Bhave Rural Hospital, Jawaharlal Nehru Medical College, Datta Meghe institute of medical sciences, Sawangi, Wardha, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20164603

Keywords:

Neonatal thrombocytopenia, Neonatal intensive care unit, Prematurity, Sepsis

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. 

References

Roberts I, Murray NA. Neonatal thrombocytopenia: causes and management. Arch Dis Child Fetal Neonatal Ed. 2003;88(5):F359-64.

Roberts I, Murray NA. Neonatal thrombocytopenia: new insights into pathogenesis and implications for clinical management. Curr Opin Pediatr. 2001;13(1):16-21.

Gupta A, Mathai SS, Kanitkar M. Incidence of thrombocytopenia in neonatal intensive care unit. Med J Armed Forces India. 2011;67(3):234-6.

Nandyal SS, Shashikala P, Sahgal V. Study of thrombocytopenia in neonatal intensive care unit. Indian J Pathol Oncol. 2016;3(1);55-9.

Merchant R, Irani A, Desai M, Mehta BC, Rodrigues R. Neonatal thrombocytopenia. Indian J Pediatr. 1981;48(393):447-3.

Merchant RH. Neonatal thrombocytopenia. Ind J Med Sci. 1989;43(5):132-5.

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):41-5.

Ghamdi AM, Umran KA, Buali WA. A practical approach to assessment of neonatal thrombocytopenia in NICU. J Neonatal Perinatal Med. 2008;1(3):175-80.

Petrova A, Bonifacio L, Nanjundaswamy S, Mehta R. Thrombocytopenia related neonatal outcome in preterms. Indian J Pediatr. 2007;74(3):269-74.

Hanoudi BM. Study of risk factors for neonatal thrombocytopenia in preterm infants. Mustansiriya Med J. 2015;14(1):64-9.

Younis S, Sheikh MA, Raza AA. Diagnostic accuracy of C-reactive protein in neonatal sepsis. J Bioresource Manage. 2014;1(1):33-42.

Chandra A, Rao MN, Srinivas M, Shyamala S. Rapid diagnostic tests in neonatal septicemia. Indian J Pediatr. 1988;55(6);947-53.

Antoniette BWM, Flora DIP. Clinical correlation of neonatal and maternal haematological parameters as predictors of neonatal sepsis. Pediatr Infect Dis Society Philippines J. 2005;9(2):36-43.

Schuchat A, Zywicki SS, Dinsmoor MJ, Mercer B, Romaguera J, O’Sullivan MJ. Risk factors and opportunities for the prevention of early onset neonatal sepsis: a multicenter case-control study. Paediatr. 2000;105:21-6.

Kuruvilla KA, Pillai S, Jesudasan M, Jana AK. The bacterial profile of sepsis in a neonatal unit in south India. Indian Paediatr. 1998;35:851-8.

Patil S, Mangshetty R, Patil B. Outcome of neonates with thrombocytopenia. J Evolution Med Dental Sci. 2014;3(17):4533-8.

Oren H, Irken G, Oren B, Olgun N, Ozkan H. Assessment of clinical impact and predisposing factors for neonatal thrombocytopenia. Indian J Pediat. 1994;61(5):551-8.

Charoo BA, Iqbal JI, Mushtaq S. Nosocomial sepsis-induced late onset thrombocytopenia in a neonatal tertiary care unit: a prospective study. Hematol Oncol Stem Cell Ther. 2009;2(2):349-53.

Anil KG, Kumeri S, Singhal A. Neonatal thrombocytopenia and platelet transfusion science. Asian J Transfusion Sci. 2012;6(2):41-2.

Castle V, Andrew M, Kelton J, Giron D, Johnston M, Carter C. Frequency and mechanism of neonatal thrombocytopenia. J Pediatr. 1986;108(5):749-55.

Zaccheaus AJ, Oburu JE. Pattern and prevalence of neonatal thrombocytopenia in port Harcourt Nigeria. Pathol Laboratory Med Intern. 2010;2:27-31.

Boskabadi H, Mafinezhad S, BagherF, Bozorgnia Y. Incidence of thrombocytopenia in idiopathic hyperbilirubinemic newborns. Maced J Med Sci. 2014;7(2):261-4.

Khera MS, Gupta CR. Incidence of thrombocytopenia following phototherapy in hyperbilirubinemic neonates. MJAFI. 2011;67:329-32.

Zieve PD, Solomon HM, Krevans JR. The effect of hematoporphyrin and light on human platelets. I morphol functional, and biochemical changes. J Cell Physiol. 1966;67:271-9.

Maurer HM, Haggins JC, Still WJ. Platelet injury during phototherapy. Am J Hematol. 1976;1:89-96.

Pishva N, Pishva H. Incidence of thrombocytopenia in hyperbilirubinemic neonates during phototherapy. Acta Medica Iranica. 2000;38:7-9.

Bhakoo ON, Singh M. Perinatal risk factors in neonatal bacterial sepsis. Indian J Pediatr. 1988;55(6)941-6.

Downloads

Published

2016-12-21

Issue

Section

Original Research Articles