Trombocitopenija kao jedan od razloga produžene hospitalizacije na Odeljenju neonatalne intenzivne nege

Evlijana Zulić,Devleta Hadžić

doi:10.24125/sanamed.v14i3.352

Abstract

The aim of this paper was to present the occurrence and severity of thrombocytopenia, with intracranial and another bleeding in neonates with sepsis, analyze the risk factors for the development of thrombocytopenia and compare it with the length of hospitalization in the Neonatal Intensive Care Unit (NICU). Thrombocytopenia is a platelet count <150 x 109/L and is common in newborns during hospitalization in the NICU. In the early days of life, the most common causes of thrombocytopenia in newborns are conditions that lead to fetal hypoxia, intrauterine growth failure, maternal hypertension, and sepsis. In this study were included all newborns with thrombocytopenia, who were hospitalized in NICU, Children's Disease Clinic, University Clinical Centre in Tuzla, from 01. 01. 2014 to 01. 01. 2019. In our results, 379 newborns had severe, 337 moderate, and 127 milder forms of thrombocytopenia, without a statistically significant difference in the incidence of thrombocytopenia between groups of neonates born < 37 GW and 37 GW. Sepsis was the most common cause of thrombocytopenia, 300 children had early sepsis and 190 late. We found the statistically significant difference in intracranial hemorrhage of the second degree and pulmonary hemorrhage among neonates born < 37 GW in relation to newborns born 37 GW. A statistically significant effect of length of stay of our neonates in the Department of Neonatal Intensive Therapy and morbidity was shown in relation to the lower gestational age and lower platelet counts. Conclusion: Timely diagnosis of the cause and development of thrombocytopenia with adequate and effective treatment can reduce the mortality and morbidity of newborns with perinatal risk for neonatal thrombocytopenia.

Highlights

Thrombocytopenia by definition is reduced platelet count < 150 x 109/L and frequent finding in neonates during hospitalization in the Neonatal Intensive Care Unit (NICU) [1]
In the early days of life, the most common causes of thrombocytopenia in newborns are conditions that lead to fetal hypoxia, intrauterine growth failure, maternal hypertension, and sepsis
In this study were included all newborns with thrombocytopenia, who were hospitalized in NICU, Children’s Disease Clinic, University Clinical Centre in Tuzla, from 01. 01. 2014 to 01. 01. 2019

Summary

Introduction

In the first days of life, the most common causes of thrombocytopenia in neonates are antibodies mediated by platelet destruction, intrauterine growth retardation, and maternal hypertension, along with other factors associated with chronic fetal hypoxia. Antibodies mediated by platelet destruction are further classified into neonatal alloimmune thrombocytopenia when the mother’s antibodies recognize fetal platelets as foreign and destroy them. It could be a passive transfer of maternal autoantibodies that are produced in the mother due to the existence of an autoimmune disease, such as systemic lupus or immune thrombocytopenic purpura, when the platelets are destroyed. Congenital infections, the causative agents of toxoplasmosis, measles, cytomegalovirus, herpes simplex virus, and fungal infections are possible causes of thrombocytopenia in the neonatal period

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