Evaluation of platelet and its indices as a marker of neonatal sepsis: a prospective case control study

Ratana Ram Choudhary, Mohan Makwana, Harish Kumar Mourya, Jagdish Dabi, Kartika Gulati


Background: Neonatal sepsis is major cause of neonatal morbidity and mortality worldwide. Blood culture and sepsis screening are currently used method, but their utility is limited due to delayed reporting and increased cost. Platelet indices are one such set of parameters which can be helpful in the future diagnosis of neonatal sepsis. This study was aimed to evaluate the significance of platelet indices either alone or in combination with existing sepsis screen as a marker of neonatal sepsis.

Methods: Neonates admitted in the neonatal unit of Hospital and showing signs and symptoms of sepsis, and/or born to mothers with risk factor for sepsis were included in this study. Investigations sent for all these neonates included blood culture, sepsis screen (CRP, micro ESR, TLC, ANC, IT ratio) and platelet indices (Platelet count, MPV, PDW).

Results: In present study, 81.12% neonates in case group had platelet count less than 1.5lacs/mm3 while in control group 20.91% neonates only had the same. This difference was statistically significant, (p<0.0001). Similarly, 70.91% neonates in case group had MPV more than >10.8 fl whereas in control group only 26.53% neonates had the same, with difference was statistically significant, (p<0.0001) Similarly, 65.81% neonates in case group and 34.69% in control group had PDW more than 19.1fl and this difference was statistically significant, (p=0.0001).

Conclusions: High PDW, high MPV and low platelet count are more associated with neonatal sepsis. So, platelet and its indices may be used as a sensitive marker to identify septic babies and it may be combined with existing sepsis screen to specifically exclude non-septic case.


Mean platelets volume (MPW), Neonatal sepsis, platelets, Platelet distribution width (PDW)

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Shankar MJ, Aggarwal R, Deorari AK, Paul VK. Symposium on AIIMS protocols in neonatology III- Sepsis in new-born. Indian J Pediatr. 2008; 75(103):261-6.

Singh SA, Dutta S, Narang A. Predictive clinical scores for diagnosis of late onset neonatal septicaemia. J Trop Pediatr. 2003;49(4):235-9.

Philip AG, Hewitt JR. Early Diagnosis of Neonatal Sepsis. Paediatri. 1980;65(5):1036-41.

Airede A, Lim NL, Wong YH, Boo NY, Kasim MS, Chor CY. Bacteraemic infections in a neonatal intensive care unit: a nine months survey. Med J Malaysia. 1995;50(1):59-63.

Mouzinho A, Rosenfield CR, Sanchez PJ, Risser R. Revised Reference Ranges For Circulating Neutrophils in very-low-birth-weight neonates. Pediatri. 1994;94:76-82.

Abdulla A, Maghayreh M, Khriesat W. The Effect of Neonatal Sepsis on Platelet Count and their Indices. J Med J. 2008;42(2):82-86.

Sartaj A. Bhat, Suhail A. Naik, WasimRafiq, Syed Tariq A. Incident of Thrombocytopenia and Changes in Various Platelet Parameter in Neonates with blood culture positive Sepsis. Int J Pediatr. 2015;3(1)757-66.

Ahmad MS, Waheed A. Platelet Counts, MPV and PDW in Culture Proven and Probable Neonatal Sepsis and Association of Platelet Counts with Mortality Rate. J College Physician Surg Pak. 2014;24:340-4.

Kudawla M, Dutta S, Narang A. Validation of a Clinical Score for the diagnosis of late onset neonatal septicaemia in babies weighing 1000-2500 g. J Trop Pediatr. 2008;54(1):66-9.

Arad ID, Alpan G, Sznajderman SD, Eldor A. The mean platelet volume (MPV) in the neonatal period. Amer J Perinatol. 1986;3(1):1-3.

Kassawneh M, Khade Y,Abuqqtaish N. Clinical features of neonatal sepsis caused by resistant Gram negative bacteria. Pediatr Int. 2009;51(3):332-6.

Maucha V, Rasia U, Sikka M, Faridi MMA, Madan N. Utility of haematological parameter and the C- Reactive protein in detection of Neonatal sepsis. J Pediatr and Child Health 2002; 38:459-64.