Risk Factors of Thrombocytopenia in Newborns Admitted to the Neonatal Care Unit

International Journal of Medical Science

© 2023 by SSRG - IJMS Journal

Volume 10 Issue 6

Year of Publication : 2023

Authors : Rania Fakih, Oday Jouni

10.14445/23939117/IJMS-V10I6P107

How to Cite?

Rania Fakih, Oday Jouni, "Risk Factors of Thrombocytopenia in Newborns Admitted to the Neonatal Care Unit," SSRG International Journal of Medical Science, vol. 10,  no. 6, pp. 43-47, 2023. Crossref, https://doi.org/10.14445/23939117/IJMS-V10I6P107

Abstract:

Background: Thrombocytopenia remains a common complication in neonates admitted to the neonatal intensive care unit(NICU) with poor outcomes, especially in severe cases. Objective: This study aimed to evaluate the risk factors associated with the occurrence of thrombocytopenia in neonates .Materials and Methods: An analytic prospective cohort study was conducted for the period of one year (2021 – 2022) at Tishreen University Hospital in Lattakia-Syria. The study included two groups of neonates that were compared: group I consisted of 153 neonates with thrombocytopenia, whereas group II consisted of 258 neonates without thrombocytopenia. Results: The results showed that 37.2% of the study population had thrombocytopenia, including 39.8% of mild grade,34.6% of moderate grade, and 25.5% of severe grade. The prevalence of thrombocytopenia was increased significantly with decreasing gestational age (p:0.0001), low birth weight (p:0.005), presence of gestational hypertension(p:0.001), premature rupture of membranes(p:0.002), perinatal asphyxia(p:0.0001), respiratory distress syndrome(p:0.0001) and sepsis (p:0.0001). Gestational age <37 weeks (RR 4.2), pregnancy hypertension (RR 2.9), perinatal asphyxia (RR 2.7), sepsis (RR 6.3), and respiratory distress syndrome(RR 4.1) were independent factors associated with the risk of progression thrombocytopenia .Conclusion: There is an important prevalence of thrombocytopenia in our health center, and the presence of prematurity, pregnancy hypertension, perinatal hypoxia, sepsis, and respiratory distress syndrome are all warning flags that may predispose to thrombocytopenia.

Keywords:

Neonates, Prematurity, Risk factors, Thrombocytopenia.

References:

[1] Irene Roberts, Simon Stanworth, and Neil A Murray, “Thrombocytopenia in the Neonate,” Blood Reviews, vol. 22, no. 4, pp. 173- 186, 2008.
[CrossRef] [Google Scholar] [Publisher Link]
[2] Hugo Donato, “Neonatal Thrombocytopenia: A Review: Definitions, Differential Diagnosis, Causes, Immune Thrombocytopenia, Arch Argent Pediatr, vol. 119, no. 3, pp. 1-13, 2021.
[CrossRef] [Google Scholar] [Publisher Link]
[3] Robert Carr, Anne M. Kelly, and Lorna M. Williamson, “Neonatal Thrombocytopenia and Platelet Transfusion- A UK Perspective,” Neonatology, vol. 107, no. 1, pp. 1-7, 2015.
[CrossRef] [Google Scholar] [Publisher Link]
[4] Suzanne F. Gunnink et al., “Neonatal Thrombocytopenia: Etiology, Management and Outcome,” Expert Review of Hematology, vol. 7, no. 3, pp. 387-395, 2014.
[CrossRef] [Google Scholar] [Publisher Link]
[5] S.E Wiedmeier et al., “Platelets Reference Ranges for Neonates, Defined using Data from Over 47.000 Patients in Multihospital Healthcare System, Journal of Perinatology, vol. 29, no. 2, pp. 130-136, 2009.
[CrossRef] [Google Scholar] [Publisher Link]
[6] Vickie L. Baer et al., “Severe Thrombocytopenia in the NICU,” Pediatrics, vol. 124, no. 6, pp. 1095-1100, 2009.
[CrossRef] [Google Scholar] [Publisher Link]
[7] Aparajita Gupta, Sheila Samanta Mathai, and Madhuri Kanitkar, “Incidence of Thrombocytopenia in the Neonatal Intensive Care Unit,” Medical Journal Armed Forces India, vol. 67, no. 3, pp. 234-236, 2011.
[CrossRef] [Google Scholar] [Publisher Link]
[8] Fatih Bolat et al., “The Prevalence and Outcomes of Thrombocytopenia in a Neonatal Intensive Care Unit: A Three-Year Report,” Pediatric Hematology and Oncology, vol. 29, no. 8, pp. 710-720, 2012.
[CrossRef] [Google Scholar] [Publisher Link]
[9] Susanne Holzhauer, and Barbara Zieger, “Diagnosis and Management of Neonatal Thrombocytopenia,” Seminars in Fetal and Neonatal Medicine, vol. 16, no. 6, pp. 305-310, 2011.
[CrossRef] [Google Scholar] [Publisher Link]
[10] Subarna Chakravorty, and Irene Roberts, “How I Manage Neonatal Thrombocytopenia,” British Journal of Hematology, vol. 156, no. 2, pp. 155-162, 2012.
[CrossRef] [Google Scholar] [Publisher Link]
[11] Robert D. Christensen et al., “Thrombocytopenia in Small for Gestational-Age Infants, Peditrics, vol. 136, no. 2, pp. 361-370, 2015.
[CrossRef] [Google Scholar] [Publisher Link]
[12] M. Sola, H. Sallomon, and R. Brown, “Thrombocytopenia in Small-for Gestational Age Infants,” Semin Perinatol, vol. 33, no. 1, 2009. 
[13] Elisabeth Resch et al., “Neonatal Thrombocytopenia – Causes and Outcomes Following Platelet Transfusions,” European Journal of Pediatrics, vol. 177, no. 7, pp. 1045-1052, 2018.
[CrossRef] [Google Scholar] [Publisher Link]
[14] Sumarth Lal Meena et al., “Clinical Profile and Outcome of Neonatal Thrombocytopenia in a Tertiary Care Hospital,” International Journal of Contemporary Pediatrics, vol. 6, no. 3, pp. 1344-1348, 2019.
[CrossRef] [Google Scholar] [Publisher Link]
[15] Sylvia R. Zekry et al., “Incidence and Risk Factors for Neonatal Thrombocytopenia among Newborns Admitted to NICU of Assiut University Children’s Hospital-A Prospective Observational Study,” Annals of Neonatology, vol. 4, no. 1, pp. 7-26, 2022.
[CrossRef] [Google Scholar] [Publisher Link]
[16] Hana Abebe Gebreselassie et al., “Incidence and Risk Factors of Thrombocytopenia in Neonates Admitted with Surgical Disorders to Neonatal Intensive Care Unit of Tikur Anbessa Specialized Hospital: A One-Year Observational Prospective Cohort Study from a Low-Income Country,” Journal of Blood Medicine, vol. 12, pp. 691-697, 2021.
[CrossRef] [Google Scholar] [Publisher Link]
[17] Keerthi Tirupathi, Keerti Swarnkar, and Jayant Vagha, “Study of Risk Factors of Thrombocytopenia,” International Journal of Contemporary Pediatrics, vol. 4, no. 1, pp. 191-196, 2017.
[CrossRef] [Google Scholar] [Publisher Link]
[18] Basil M. Hanoudi, “Study of Risk Factors for Neonatal Thrombocytopenia in Preterm Infants,” Mustansiriya Medical Journal, vol. 14, no. 1, pp. 64-69, 2015.
[Google Scholar] [Publisher Link]
[19] Anita Chandna et al., “Rapid Diagnostic Test in Neonatal Septicemia,” The Indian Journal of Pediatrics, vol. 55, no. 6, pp. 947-953, 1988.
[CrossRef] [Google Scholar] [Publisher Link]
[20] Willa Antoniette B. Mayuga, and Pura Flor D. Isleta, “Clinical Correlation of Neonatal and Maternal Haematological Parameters as Predictors of Neonatal Sepsis,” Pediatric Infectious Disease Society of the Philippines, vol. 9, no. 2, pp. 36-43, 2005.
[Google Scholar] [Publisher Link]
[21] Z. Eslami et al., “Thrombocytopenia and Associated Factors in Neonates Admitted to NICU during Years 2010–2011,” Iranian Journal of Pediatric Hematology and Oncology, vol. 3, no. 1, pp. 205-215, 2013.
[Google Scholar] [Publisher Link]
[22] Hale Ören et al., “Assessment of Clinical Impact and Predisposing Factors for Neonatal Thrombocytopenia,” The Indian Journal of Pediatrics, vol. 61, no. 5, pp. 551-558, 1994.
[CrossRef] [Google Scholar] [Publisher Link]
[23] Mario E. Beiner et al., “Risk Factors for Neonatal Thrombocytopenia in Preterm Infants,” American Journal of Perinatology, vol. 20, no. 1, pp. 49-54, 2003.
[Google Scholar] [Publisher Link]
[24] Sonam S. Nandyal, P. Shashikala, and Vidhushi Sahgal, “Study of Thrombocytopenia in Neonatal Intensive Care Unit,” Indian Journal of Pathology and Oncology, vol. 3, no. 1, pp. 55-59, 2016.
[Google Scholar] [Publisher Link]
[25] P. Jack, “Analysis of Neonatal Thrombocytopenia in 356 Infant in First Hospital of Jilin University,” Pediatr Res, vol. 28, no. 148, 2013.