Publication:

Clinical profile and outcome of neonatal thrombocytopenia in a tertiary care hospital

Background Thrombocytopenia (platelet count <1,50,000/µL) is one of the most common haematological problems in neonatal intensive care units. In contrast, only 2% of the normal neonates are thrombocytopenic at birth with severe thrombocytopenia (platelet count <50,000/µL) occurring in less than 3/1000 term infants. Multiple disease processes can cause thrombocytopenia in neonates. The important causes of thrombocytopenia in neonates are sepsis, birth asphyxia, prematurity, intra-uterine growth retardation, hyperbilirubinemia, respiratory distress syndrome, meconium aspiration syndrome and low birth weight. Apart from platelet count, bleeding manifestations depend on underlying ailments. The aims and objective were to study the clinical profile, etiology and outcome of neonatal thrombocytopenia in a tertiary care hospital.

Methods Prospective study involving 100 neonates with or developed neonatal thrombocytopenia in NICU.

Results In present study, 100 new-borns with thrombocytopenia 46% were mild, 35% were moderate and 19% were severe thrombocytopenia. 51 (51%) had early onset neonatal thrombocytopenia and 49 (49%) babies had late onset neonatal thrombocytopenia. Anaemia was the dominant maternal predisposing risk factor. Sepsis was the most common cause of neonatal thrombocytopenia. Most common symptom was apnoea. Sepsis, RDS and NEC had significantly contributed to mortality. Most common cause of death was sepsis followed by RDS and NEC.

Conclusions Neonatal thrombocytopenia is a treatable and reversible condition. Hence, it is important to identify neonates at risk and initiate transfusion therapy to prevent severe bleeding and potentially significant morbidity. Anaemia and PROM were the commonest maternal risk factors. Therefore, author recommended that babies born to mothers with these risk factors should be closely monitored for thrombocytopenia.