Abstract
We evaluated the causes for neonatal thrombocytopenia (NT), the duration of NT, and the indications of platelet transfusions (PT) by means of a retrospective cohort study over a 23-year period. Neonates with NT were identified via ICD-10 code D69.6. Of 371 neonates (1.8/1000 live births) with NT, the majority (312; 84.1%) had early onset thrombocytopenia, and 282 (76%) were preterm born. The most frequent causes for NT were early and late onset sepsis and asphyxia. The mean duration of thrombocytopenia was 10.2 days and was negatively correlated (KK = − 0.35) with the number of PT. PT were given to 78 (21%) neonates, 38 (49%) of whom had very severe NT. The duration of NT was positively related to the severity of NT and the number of subsequent PT. A mortality rate of 10.8% was significantly associated with bleeding signs (p < 0.05) and correlated with increasing number of PT (p < 0.05) but not with the severity of NT (p = 0.4). In the case of relevant hemorrhage, PT did not influence the mortality rate (p = 0.09). All deaths followed neonatal sepsis.Conclusions: Prematurity and diagnoses including early and late onset sepsis and asphyxia were the most common causes of NT. Mortality was not associated with the severity of NT but increased with the number of PT.What is Known:• The causes for neonatal thrombocytopenia (NT) are well known.• The effects of platelet transfusions (PT) and its indications are still a matter of debate and recommendations differ widely.What is New:• The duration of NT is positively related to the severity of NT and the number of subsequent PT.• The mortality rate is not associated with the severity of NT but increases with increasing numbers of PT and in the case of relevant intraventricular hemorrhage (≥ grade II), PT does not influence the mortality rate.
Highlights
Thrombocytopenia develops in 18–35% of neonates admitted to intensive care units
Mortality was not associated with the severity of neonatal thrombocytopenia (NT) but increased with the number of platelet transfusions (PT)
The duration of NT is positively related to the severity of NT and the number of subsequent PT
Summary
Thrombocytopenia develops in 18–35% of neonates admitted to intensive care units. In addition, Sola et al [1] showed that the likelihood of developing thrombocytopenia increases withEur J Pediatr (2018) 177:1045–1052 the degree of prematurity. Thrombocytopenia develops in 18–35% of neonates admitted to intensive care units. Sola et al [1] showed that the likelihood of developing thrombocytopenia increases with. Eur J Pediatr (2018) 177:1045–1052 the degree of prematurity. Roberts and Murray [2] calculated that low-birthweight infants were at a 2.52-fold increased risk for thrombocytopenia. The rate and severity of thrombocytopenia in neonates of pregnancy-induced hypertensive mothers vary. Chakravorty and Roberts [3] demonstrated in those pregnancies complicated by preeclampsia that the usual course of thrombocytopenia includes diagnosis within the first 2–3 days and resolution by 7–10 days of life in most cases. Thrombopoiesis, is a complex process that results in the production of thrombopoietin as the thrombopoietic stimulus leading to the generation and proliferation of megakaryocyte progenitors
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