ABSTRACT

Thrombocytopenia has recently become a significant problem in patients admitted to neonatal intensive care unit. In this population, the cases of acquired thrombocytopenia is more noteworthy. In this study, it was aimed to evaluate the causes of acquired thrombocytopenia in the neonatal intensive care unit.

Total of 588 infants, who admitted to NICU between 2013-2014, enrolled in the study and they were divided into three groups according to their platelet levels; mild (100-150x10⁹/mm³), moderate (50-99x10⁹/mm³) and severe (<50x10⁹/mm³) thrombocytopenia. İnfants Infants were classified into two groups according to the time at onset; early onset (within first 72 hours) and late-onset (after 72 hours) thrombocytopenia. Prenatal risk factors for thrombocytopenia; maternal hypertension and gestational diabetes, preeclampsia, delivery mode and active resuscitation at birth, perinatal asphyxia and neonatal risk factors; gestational age, gender, comorbid diagnoses were studied.

Thrombocytopenia was seen in 79 of 588 cases (13.4%). 28 (35.0%) of them had mild, 24 (30.0%) had moderate and 27 (34.0%) severe thrombocytopenia. Infants with early onset thrombocytopenia were 56.9% (n=45) of cases. 60.0% of neonates (n=48) were preterm, 40.0% of neonates was the term. 40.0% of cases were girls. According to the mode of delivery, 58 neonates were born by cesarean section. 43 babies were (54.0%) initially actively resuscitated in the delivery room. The most common neonatal factor was perinatal asphyxia. The most common diagnosis were related with respiratory problems (respiratory distress syndrome, congenital pneumonia, transient tachypnea of the newborn, meconium aspiration syndrome) (n=47) and the other diagnosis were hyperbilirubinemia (ABO incompatibility) (n=12), sepsis (n=9), congenital heart diseases (n=4), convulsion (n=2), hypoglycemia (n=2), Down syndrome (n=1), nutrition intolerance (n=1), Pierre Robin Syndrome (n=1).

In the neonatal intensive care unit, thrombocytopenia incidence was determined as 13.4%. Maternal hypertension, pre-eclampsia, and prematurity were prominent risk factors for early onset thrombocytopenia, neonatal sepsis was the prominent factor of late-onset thrombocytopenia in newborn.

Keywords: Neonate, thrombocytopenia, neonatal intensive care unit