Study of changes noted in the platelet count in cord blood of neonates born to hypertensive mothers in a tertiary care hospital, Bangalore, India


  • Vijayalaxmi Gagandeep Department of Paediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Mohinish S. Department of Paediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India
  • Mallesh K. Department of Paediatrics, Bangalore Medical College and Research Institute, Bangalore, Karnataka, India



Bleeding, Early onset sepsis, Hypertensive disorders, Neonatal thrombocytopenia, Pre-eclampsia, Prematurity


Background: Hypertensive disorders of pregnancy pose several problems to both mother and newborn. Complications in new-born like intrauterine death (IUD), intrauterine growth retardation (IUGR), perinatal asphyxia, neonatal sepsis and bleeding disorders are associated with toxemia of pregnancy. To decrease the perinatal morbidity and mortality, babies of hypertensive mothers should be carefully monitored and managed. Aim of this study was to establish the changes in total platelet count in umbilical cord blood.

Methods: This is a hospital based prospective observational study which included the babies born to mothers having hypertensive disorders of pregnancy, total cases accounting about 158. Detailed clinical history taken including details of labour and clinical examination done.  In all the subjects, 2 ml of umbilical cord blood anticoagulated with EDTA was collected and haematological tests for total platelet count (TPC) count was done.

Results: This study shows that the incidence of neonatal thrombocytopenia is 43.67%. The incidence of sepsis among thrombocytopenia group accounts for about 60% in gestational hypertension, 64.2% in pre-eclampsia and 50% in eclampsia group.

Conclusions: With respectively, these findings it can be concluded that the incidence of Neonatal Thrombocytopenia is significantly higher in babies born to HDP mothers and it can be taken as a marker to evaluate Sepsis in such a situation in resource limited setting. As less number of studies is available in this area of interest, this study supports the cause.


ibai BM. Diagnosis and management of gestational hypertension and preeclampsia. Obstet Gynecol. 2003 Jul;102(1):181-92.

WHO. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia. Available at: Accessed on 27 September 2019.

American College of Obstetricians and Gynaecologists. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013 Nov;122(5):1122-31.

Steer P, Lupton M. Eugene Oteng-Ntim. Hypertensive disease in pregnancy. Rennie and Robertson’s textbook of neonatology. 4th edition. Churchill Livingstone; 2005 reprint 2008:179-181.

Cunningham, Leveno, Bloom, Rouse, Spong. Hypertensive Disorders of pregnancy. William’s Obstetrics. 23rd edition. McGraw Hill; 2010:693-694.

Mondal GP, Raghavana M, Bhat BV, Srinivasan S . Neonatal septicemia among in born and out born babies in a referral hospital. Ind J Pedlatr. 1991 Jul-Aug;58(4):529-33.

Raizada N, Lal A, Bhatia RC, Jain BK, Chander K, Goyal A. Neonatal thrombocytopenia due to pregnancy induced hypertension. Ind j pediatr. 1996 Mar 1;63(2):226-8.

Dutta DC. Textbook of Obstetrics. 8th edition. Calcutta; New Central Book Agency; 2004:255-281.

Fraser SH, Tudehope DI. Neonatal neutropenia and thrombocytopenia following maternal hypertension. J Paediatr Child Health. 1996 Feb;32(1):31-4.

Backes CH, Markham K, Moorehead P, Cordero L, Nankervis CA, Giannone PJ. Maternal preeclampsia and neonatal outcomes. J Pregnancy. 2011;2(1).

McElrath TF. Preeclampsia and related conditions. In: Cloherty JP, Eichenwald EC, Hansen AR, Stark AR. Manual of neonatal care. 7th edition. New Delhi: Lippincott Williams and Wilkins;2008:28-31.

Mouzinho A, Rosenfeld CR, Sanchez PJ, Risser R. Effect of maternal hypertension on neonatal neutropenia and risk of nosocomial infection. Pediatr. 1992 Sep 1;90(3):430-5.

Sivakumar S, Bhat BV, Badhe BA. Effect of pregnancy induced hypertension on mothers and their babies. Ind J Pediatr. 2007 Jul 1;74(7):623-5.

Kumar S, Haricharan K. Neonatal thrombocytopenia associated with gestational hypertension, preeclampsia and eclampsia: A case-control study. Inter J Contemporary Pediatr. 2016 Jan;3(1):16-21.

Gelband H, Liljestrand J, Nemer L, Islam M, Zupan J. The evidence base for interventions to reduce maternal and neonatal mortality in low and middle-income countries. CMH Working Paper Series. WG5 Paper. Maternal and neonatal mortality. 2012;(5).

Chaim SR, Oliveira SM, Kimura AF. Pregnancy-induced hypertension and the neonatal outcome. Acta Paulista Enfermagem. 2008 Mar;21(1):53-8.

Moallem M, Koenig JM. Preeclampsia and neonatal neutropenia. Neo Rev. 2009 Sep 1;10(9):e454-9.

Kleckner HB, Giles HR, Corrigan Jr JJ. The association of maternal and neonatal thrombocytopenia in high-risk pregnancies. Am J Obstetr Gynecol. 1977 Jun 1;128(3):235-8.

Burrows RF, Andrew M. Neonatal thrombocytopenia in the hypertensive disorders of pregnancy. Obstetr Gynecol. 1990 Aug;76(2):234-8.

Moodley J, Naidu S, Chetty D, Adhikari M, Gouws E. Neonatal thrombocytopenia in preeclamptic women with low platelet counts. Hypertension Pregnancy. 1996 Jan 1;15(3):297-304.

Sultana F, Parthiban R, Shariff S. Thrombocytopenia in pregnancy induced hypertension. J Med Sci Health. 2015;1(2):19-24.

Thiagarajah S, Bourgeois FJ, Harbert Jr GM, Caudle MR. Thrombocytopenia in preeclampsia: associated abnormalities and management principles. Am J Obstetr Gynecol. 1984 Sep 1;150(1):1-7.

Mosayebi Z, Nariman S, Hosseini L, Movahedian AH. Evaluation Of laboratory disorders in admitted neonates in NICU who were born to preeclamptic mothers. J Comprehensive Pediatr. 2013;4(4):194-9

Kurlat I, Sola A. Neonatal polycythemia in appropriately grown infants of hypertensive mothers. Acta Paediatr. 1992 Sep;81(9):662-4.

Bhat YR, Cherian CS. Neonatal thrombocytopenia associated with maternal pregnancy induced hypertension. Ind J Pediatr. 2008 Jun 1;75(6):571-3.

Bhaumik S, Ghosh S, Haldar KK, Mitra PK, Manna B. Risk of early onset neonatal septicemia in babies born to mothers with pre-eclampsia. Ind Pediatr. 2000;37(7):775-9.

Chakravorthy S, Roberts I. How 1 manage Neonatal Thrombocytopenia. Brit J Hematol. 2011;2011.

Castle V, Andrew M, Kelton J, Giron D, Johnston M, Carter C. Frequency and mechanism of neonatal thrombocytopenia. J Pediatr. 1986 May 1;108(5):749-55.

Íren H, Irken G, Íren B, Olgun N, Ízkan H. Assessment of clinical impact and predisposing factors for neonatal thrombocytopenia. Ind J Pediatr. 1994 Sep 1;61(5):551-8.

Beiner ME, Simchen MJ, Sivan E, Chetrit A, Kuint J, Schiff E. Risk factors for neonatal thrombocytopenia in preterm infants. Am J Perinatol. 2003;20(01):049-54.






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