Causes and Neonatal Outcome of Early-Onset Thrombocytopenia in Preterm Neonates

ABSTRACT

PURPOSE: Thrombocytopenia is the most common hematologic abnormality diagnosed in the neonatal intensive care unit (NICU). We investigated the causes and neonatal outcomes of early-onset thrombocytopenia in preterm neonates and compared clinical outcomes between neonates in an early-onset thrombocytopenia group who have received and those who have not received platelet transfusion in order to assess the clinical significance of early-onset thrombocytopenia in preterm infants. METHODS: We retrospectively reviewed the medical records of preterm neonates born earlier than 34 weeks' gestation who were admitted to the NICU between January 2005 and September 2014. 412 preterm neonates born earlier than 34 weeks' gestation were enrolled. The early-onset thrombocytopenia group (n=90) had a platelet count < or =150,000/mL within the first 72 hours of life. We investigated maternal and neonatal characteristics, and neonatal outcomes in the group and compared these with those of a control group (n=322). RESULTS: The neonates with early-onset thrombocytopenia tended to have lower gestational age, birth weight and Apgar scores than controls. Maternal hypertension and lower Apgar score at birth were predictive factors of early-onset thrombocytopenia. No differences in clinical outcomes were observed between the two groups. Clinical outcomes did not significantly different between the groups regardless of whether the neonates received platelet transfusion or not. CONCLUSION: Early-onset thrombocytopenia had no effect on the neonatal outcomes of the preterm infants. Platelet transfusion did not affect the clinical outcomes of the neonates in the early-onset thrombocytopenia group. Thus, we suggest a lager controlled study on early-onset thrombocytopenia in newborns in order to establish more-efficient treatment guidelines.