Minerva Pediatrica 2019 Jul 25

DOI: 10.23736/S0026-4946.19.05542-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Prevalence, risk factors and predictors of severity of neonatal thrombocytopenia in neonatal intensive care units: a single center study

Rui P. RIBEIRO ¹ ✉, Filipa FLOR-DE-LIMA ^{1, 2}, Henrique SOARES ^{1, 2}, Gustavo ROCHA ², Hercília GUIMARÃES ^{1, 2, 3}

¹ Faculty of Medicine, University of Porto, Porto, Portugal; ² Neonatal Intensive Care Unit, Centro Hospitalar Universitário São João, Porto, Portugal; ³ Cardiovascular R&D Unit, Faculty of Medicine, University of Porto, Porto, Portugal

BACKGROUND: Thrombocytopenia is a common hematological disorder seen in the neonatal period, especially in newborns admitted to the Neonatal Intensive Care Unit (NICU). The clinical and laboratorial presentation is heterogeneous, with different underlying causes and risk factors. There are still few studies about some possible risk factors and their influence on the newborn’s clinical outcome. The aim of this study was to assess the prevalence, risk factors and predictors of severity of thrombocytopenia in a level III NICU.
METHODS: Retrospective study of newborns with thrombocytopenia (platelet count less than 150×109/L) admitted from January 1, 2008 to December 31, 2017. Newborns admitted after the first 72 hours of life and those with thrombocytopenia related to surgical intervention were excluded.
RESULTS: Out of 187 neonates with thrombocytopenia, a total of 134 neonates were included in the study, corresponding to a prevalence of 3.3%. One hundred fourteen (85%) neonates had an early onset presentation (EOT) and 20 (15%) neonates had a late onset presentation (LOT); 68 (50.7%) neonates had severe and 66 (49.3%) had non-severe thrombocytopenia. Sepsis was identified as an independent predictor of LOT. Sepsis by gram- negative bacteria was identified as an independent predictor for severe thrombocytopenia.
CONCLUSIONS: Identification of risk factors, early diagnosis and treatment of the underlying causes are crucial for a better approach of neonatal thrombocytopenia. A strong association between sepsis and sepsis by gram-negative bacteria with LOT and severe thrombocytopenia, respectively, enhances the importance of nosocomial sepsis control in NICU.

KEY WORDS: Thrombocytopenia; Infant; Newborn; Intensive care unit, Neonatal