Thrombocytopenia burden and its associating Risk factors: A cross-sectional study at a tertiary care set up
Abstract
Thrombocytopenia is a very common finding in the neonatal intensive care unit. This study was designed with aim to study the risk factors associated with neonatal thrombocytopenia. In this cross-sectional observational study, 263 newborns admitted in the NICU from October 2016 to December 2016 were enrolled in the study. Proportion of thrombocytopenia was found along with its various neonatal and maternal risk factors associated. Chi-square test was used to find out association. Neonatal thrombocytopenia was found in 29% of neonates; 64 % had early onset and 36 % had late onset thrombocytopenia. Mild, moderate and severe thrombocytopenia was found in 49 %, 34 % and 17 % respectively. Thrombocytopenia was found to be associated with APH and PROM among maternal factors and with LBW, prematurity and birth asphyxia among neonatal factors.
Keywords
Download Options
Introduction
Thrombocytopenia is one of the common hematological problems in a neonatal intensive care unit particularly in premature and sick newborns.1 Incidence varies greatly generally it accounts forupto20 to 40 per cent of the newborn admissions to NICU.2,3,4,5,6
Thrombocytopenia is defined as a platelet count of less than 1,50,000 per cmm regardless of the gestational age.7 Based on the time of onset, thrombocytopenia further classified as early onset that is within first 72 hours of birth and late onset that is after 72 hours of life.8 Grading of thrombocytopenia further done into mild, moderate and severe based on platelet count. Mild thrombocytopenia is defined as a platelet count of 1,00,000 to 1,50,000 per cmm, moderate as count between 50,000 to less than 1,00,000 per cmm and severe as count less than 50,000 per cmm. Multiple neonatal and maternalfactors can cause thrombocytopenia in the neonates admitted in NICU.9,10,11 The common neonatal factors being pre-maturity, IUGR/LBW, sepsis and asphyxia.12,13,14 Maternal factors generally associated are APH, PROM, Pre-eclampsia and eclampsia and other chronic illnesses.12,13,14
Thrombocytopenia is a significant cause of morbidity and mortality in the NICU and if not managed appropriately it can result in severe consequences like pulmonary and intracranial hemorrhage.
This present study was undertaken to found various neonatal and maternal risk factors associated with thrombocytopenia in the neonates admitted in NICU.
Conclusion
This study concludes that Neonatal thrombocytopenia was found in more than one in four neonates in NICU. is a very common problem in the NICU. Thrombocytopenia was found to be associated with APH and PROM among maternal factors and with LBW, prematurity and birth asphyxia among neonatal factors. By treating the various maternal and neonatal factors associated with thrombocytopenia it can reduce neonatal morbidity and mortality.