Prevalence and clinical correlates of neonatal thrombocytopaenia in a tertiary healthcare facility in a low-income country

Chinazaekpere Oluebube Obiweluozor; Christian Chukwukere Ogoke; Anthony Nnaemeka Ikefuna; Tochukwu Chukwukadibia Ezeofor

doi:10.18203/2349-3291.ijcp20212465

Authors

Chinazaekpere Oluebube Obiweluozor Department of Paediatrics, Federal Medical Centre, Owerri, Nigeria
Christian Chukwukere Ogoke Department of Paediatrics, King Fahad Central Hospital, Abu Arish, Jizan, Saudi Arabia
Anthony Nnaemeka Ikefuna Department of Paediatrics, Faculty of Medical Sciences, University of Nigeria, Enugu (UNEC), Enugu, Nigeria
Tochukwu Chukwukadibia Ezeofor Department of Paediatrics, Federal Medical Centre, Owerri, Nigeria

DOI:

https://doi.org/10.18203/2349-3291.ijcp20212465

Keywords:

Thrombocytopaenia, Platelet count, Special care baby unit, Sick neonate, Bleeding, Petechiae

Abstract

Background: Thrombocytopaenia is known to complicate many neonatal illnesses and contributes significantly to morbidity and mortality. Early diagnosis and treatment are necessary to avoid complications. There are a few studies on the prevalence of neonatal thrombocytopaenia in South Eastern Nigeria. This study aimed to determine the prevalence and clinical correlates of neonatal thrombocytopaenia in South Eastern Nigeria.

Methods: The prospective study was carried out over a period of eight months (December 2015 to July 2016). One hundred and fifty nine neonates admitted consecutively into the Special Care Baby Unit of the Federal Medical Centre, Owerri were recruited and evaluated for thrombocytopaenia on admission and after forty-eight hours in the study. Blood platelet was analysed using Sysmex KX-21N automatic platelet analyser and manual counting. Thrombocytopenia was defined as blood platelet less than 100×10⁹/L.

Results: The subjects included 89 (56%) males and 70 (44%) females. The prevalence of neonatal thrombocytopaenia was 6.3% on admission and 8.3% after forty-eight hours. Bleeding from orifices (p=0.012), prolonged pregnancy (p=0.047) and petechiae (p=0.020) were clinical correlates significantly associated with thrombocytopaenia. No specific clinical diagnosis was significantly associated with thrombocytopaenia, though the odds of a newborn having thrombocytopaenia was higher in certain conditions indicating increased risk.

Conclusions: The prevalence of thrombocytopaenia in this study suggests that platelet count should be done for neonates admitted into special care baby units in resource-poor settings. This should be more in neonates with bleeding from orifices, prolonged pregnancy and petechiae.

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References

Veneri D, Franchini M, Randon F, Nichele I, Pizzolo G, Ambrosetti A, Thrombocytopenia: a clinical point of view. Blood Tranfus. 2009;7:75-85.

Ruggeri M, Fortunus, Rudeghiero F. Heterogeneity of terminology and clinical definitions in adult idiopathic thrombocytopenic purpura: A clinical appraisal from a systematic review of literature. Haematologica. 2008;93:98-103.

Diz-Kuciikaya R, Hacihanefioglu A, Yeneral M. Anti-phospholipid antibodies and antiphospholipid syndrome in patients presenting with Immune thrombocytopenic purpura: a prospective cohort study. Blood. 2001;98:1760-64.

Warkentin TE. An overview of the heparin-induced thrombocytopenia syndrome. Semin Thromb Hemost. 2004;30:273-83.

Sallman H and Sola-Visner M. Clinical research issues in neonatal anaemia and thrombocytopaenia. Current Opinion Pediatric. 2012;24:16-22.

Izak I, Bussel J. Management of thrombocytopenia. F1000 Prime Rep. 2014;6:16-45.

Koram KA, Aedae MM. Population based reference intervals for common blood and biochemical parameters in the Akuapem North District. Ghana Med J. 2007;41:160-66.

Bain BJ. Ethnic and sex differences in the total and differential white cell count and platelet count. J Clin Pathol. 1996;49:664-66.

Castle V, Andrew M, Kelton J. Frequency and mechanism of neonatal thrombocytopaenia. J Pediatr. 1986;108:749-55.

Nadkarni J, Patne S, Kispota R. Hypoxia as a predisposing factor for the development of early onset neonatal thrombocytopaenia. J Clin Neonatal. 2012;131-34.

Khalessi N, Khussavi N, Sanii S, Zareh Mehrjerdi F. The prevalence and risk factors for neonatal thrombocytopaenia among newborn admitted to intensive care unit of Aliasghar Children’s Hospital. Iranian J of Blood and Cancer. 2013;2:41-5.

Ezeh OK, Agho KE, Dibley MJ, Hall J, Page AN. Determinants of neonatal mortality in Nigeria: evidence from the 2008 demographic and health survey. BMC Public Health. 2014;14:521.

International Council for Standardization in Haematology Expert Panel on Cytometry and International Society of Laboratory Haematology Task Force on Platelet Counting. Platelet counting by the RBC/platelet ratio method. Am J Clin Pathol. 2001;115:460-64.

Jeremiah ZA, Oburu JE. Pattern and prevalence of neonatal thrombocytopaenia in Port Harcourt. Pathol Lab Med Int. 2010;2:27-31.

Onwukeme KE, Olomu IN, Nnanna OU. Haematological indices in healthy Nigerian neonates. Niger Med Pract. 1992;23:7-11.

Abdulrrahman MB, Adekoje MA. Haematological values in Northern Nigerian neonates. Trans R Soc Trop Med Hyg. 1983;77:786-8.

Utuk EE, Ikpeme EE, Emodi IJ, Essien EM. The prevalence of thrombocytopaenia in Plasmodium falciparum malaria in children at the University of Uyo Teaching Hospital, Uyo, Nigeria. Niger J Paed. 2014;41:28-32.

Oyedeji GA. Socioeconomic and cultural background of hospitalised children in Ilesha. Nig J Pediatr. 1985;12:111-11.

Ike SO, Nubila T, Ukaejiofo EO, Nubila IN, Shu EN, Ezema I. Comparison of haematological parameters determined by the Sysmex KX-21N automated haematology analyser and the manual counts. BMC Clin Pathol. 2010;10:3.

Burrows RF, Kelton JC. Thrombocytopaenia at delivery: a prospective survey of 6,715 deliveries. Am J Obstet Gynecol. 1999;162:731-34.

Bolat F, Kilic SC, Ofla MB, Gulhan E, Kaya A, Guven AS. The prevalence and outcomes of thrombocytopaenia in a neonatal intensive care unit: a three year report. Pediatr Hematol Oncol. 2012;29:710-20.

Ogundeyi MM, Olarewaju DM, Njokanma OF, Ogunlesi TA. Haematological profile of apparently healthy term babies aged one day, three days and six weeks delivered in Sagamu, Nigeria. Nig J Paed. 2011;38:125-30.

Sainio S, Jarvenpaa AS, Renlund M. Thrombocytopaenia in term infants: a population based study. Obstet Gynecol. 2000;95:441-46.

Sonam S, Shashikala P, Vidushi S. Study of thrombocytopaenia in neonatal intensive care unit. Indian J of pathol Oncol. 2016;3:55-9.

Sharma A, Thapar K. A prospective observational study of thrombocytopaenia in high risk of neonates in a tertiary care teaching hospital. Sri Lanka J of Child Health. 2015;44:213-19.

Patil S, Manghetty R, Patil B. Outcome of neonates with thrombocytopaenia. J Evolu Med. 2014;3:4533-38.

Taylor MR, Holland CV, Spencer R, Jackson JF, O’Connor GI, O’donnell JR. Haematological reference ranges for school children. Clin and lab Haematol. 1997;19:1-15.