Frequency and Severity of Thrombocytopenia in Neonatal Sepsis.

Maria Arabdin,Gulrukh S Khan,Maryam Shahid,Sikandar Zia,Adnan Khan,Sarbiland Khan

doi:10.7759/cureus.22665

Abstract

BackgroundNeonatal sepsis includes numerous systemic illnesses such as septicemia, meningitis, urinary tract infections, and pneumonia. In developing countries, the major reason for neonatal mortality is septicemia, which accounts for almost 50% of overall deaths. Thrombocytopenia is one of the most common hematological problems during the neonatal period, affecting the majority of sufferers admitted to the neonatal intensive care unit (NICU). The aim of our study was to find the frequency of thrombocytopenia and its severity in neonates with sepsis.MethodsThe study was conducted at the Department of Hematology at Khyber Medical University, Peshawar, Pakistan. A total of 170 neonates with an age of fewer than 28 days, both genders, and positive blood cultures were included in the study using a non-probability consecutive sampling technique. Data was recorded in predesigned questionnaires after taking informed consent. Data were recorded and analyzed using SPSS version 26 (IBM Corporation, Armonk, NY, USA).ResultsOf the 170 neonates, 104 (61.2%) were males, with a mean age of 12.12±8.88 days. The majority of the babies 73 (42.9%) were in the age group of 0-7 days. Most of the neonates 72 (42.4%) were born via normal vaginal delivery (NVD). Of the neonates, 117 (68.82%) presented with fever, and 105 (61.76%) were reluctant to feed. Furthermore, 65.29% of the neonates had thrombocytopenia, of which 34 (20%) had mild, 43 (25.3%) had moderate, and 34 (20%) had severe thrombocytopenia. In neonates with positive blood culture, the platelet level was low (p<0.001). In the case of gram-negative organisms, the level of platelets was lower as compared to gram-positive organisms (p<0.001).ConclusionSepsis is still a common cause of newborn thrombocytopenia. The fact that it is present in more than half of all culture-positive sepsis episodes indicates the severity of the condition. This condition is further defined by higher percentages of early-onset gram-negative septicemia compared to gram-positive sepsis.

Highlights

Neonatal sepsis incorporates diverse systemic ailments such as septicemia, meningitis, urinary tract infections, and pneumonia [1]
The results of our study are in good correlation with a cohort study, where 20% had severe onset of the disease, and the results revealed an almost fourfold increase in mortality in neonatal sepsis with thrombocytopenia [12]
We found that in neonatal sepsis, more than half of the neonates developed thrombocytopenia and 20% developed severe thrombocytopenia

Summary

Introduction

Neonatal sepsis incorporates diverse systemic ailments such as septicemia, meningitis, urinary tract infections, and pneumonia [1]. Its miles assessed that sepsis develops in 20% of neonates, of which 1% die in the early days [4]. Late-onset sepsis (LOS) is frequent, in VLBW neonates. One of the early indicators for neonatal sepsis is thrombocytopenia [6]. Neonatal sepsis includes numerous systemic illnesses such as septicemia, meningitis, urinary tract infections, and pneumonia. The major reason for neonatal mortality is septicemia, which accounts for almost 50% of overall deaths. The aim of our study was to find the frequency of thrombocytopenia and its severity in neonates with sepsis

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Discussion

Conclusion