Quantitative Analysis of Thrombocytes in Neonates in a Tertiary Care Centre of Southern India- A Retrospective Study

Abstract

Introduction: Thrombocytopenia is defined as a platelet count of less than 150×109/L, which is also applicable to newborn infants. It may be a result of increased platelet destruction (immune and non immune), decreased platelet production, and a combination of both or unknown. A platelet count of more than 500×109/L is considered thrombocytosis, classified as primary or essential and secondary or reactive. Abnormal platelet count being quite common, is most often neglected and it can lead to devastating complications if untreated. Aim: To study the incidence of abnormal platelet counts and to determine the risk factors associated with abnormal platelet counts in neonates admitted to the Neonatal Intensive Care Unit (NICU). Materials and Methods: A retrospective analysis of platelet count of all neonates admitted to a tertiary NICU of RL Jalappa Hospital, Tamaka, Karnataka, India, between July 2020 and June 2021 was done to determine the incidence and risk factors associated with abnormal platelet count (thrombocytopenia and thrombocytosis). Data of all the neonates were collected retrospectively from July 2021 to August 2021 and analysed. A total of 562 neonates were included in the study. Categorical data was taken and expressed in the form of frequencies and percentages. Data were entered as frequencies using Microsoft excel version 2203 and analysed using Statistical Package for Social Sciences (SPSS) software version 22.0. Chi-square and Fischer’s exact test were used to determining the significance of the data. The p-value <0.05 was considered statistically significant. Results: Out of 629 neonates admitted, 562 neonates were included in the study. Total 209 neonates had thrombocytopenia, with early thrombocytopenia being in 94 (45%) and late being in 115 (55%). Thrombocytosis was seen in only 15 neonates where 7 (46.6%) had early, and 8 (53.3%) had late thrombocytosis. The most common risk factor associated with both cases was sepsis. Placental insufficiency had a statistically significant association with thrombocytopenia (p<0.001**). Term babies had a higher incidence of thrombocytopenia and thrombocytosis, and the association with thrombocytopenia was statistically significant (p=0.043*). Conclusion: Based on the present study, it can be concluded that abnormal platelet count is quite a common finding in sick neonates. Thrombocytopenia is more common than thrombocytosis. The most common risk factor is sepsis, it should not be neglected, and appropriate treatment should be initiated once an abnormal platelet count is detected in neonates.