Thrombocytopenia in neonates: causes and outcomes

Neonatal thrombocytopenia is defined as a platelet count <150,000/mm³ in any neonate of a viable gestational age. Thrombocytopenia is one of the most common hematologic abnormality in the neonatal period. This study which is purposed to decrease prevalence of thrombocytopenia by eliminating preventable factors and to determine the treatment and clinical outcomes of neonates with thrombocytopenia, in the neonates admitted to neonatal service and neonatal intensive care unit, is designed as a retrospective study. In 3515 neonate the thrombocytopenia prevalence is found 3.8 % of all neonates ( 1.3 % in terms, 12% in preterms) and 12 % in those admitted to the neonatal intensive care unit. Sepsis and IUGR are found as the most common causes of thrombocytopenia.The analysis of the prevalance of thrombocytopenia according to years revealed that the highest prevalence was in the year 2008 by 5.3 % , and the lowest prevalance was in the year 2011 by 2.4%. When the caues of thrombocytopenia were analysed, it is seen that sepsis was the most common reason between years 2007-2009, whereas IUGR took place in 2010. On the other hand, thrombocytopenia caused by metabolic disorders, drugs and asfixia was more common in 2011.The median day of determination of thrombocytopenia was found as 1st posnatal day, median nadir platelet count was found as 3rd day, median improvement day was found as 10th day. Median platelet count was 50,000/mm³. Severe thrombocytopenia was found in 26 % of neonates and %11 of thrombocytopenic neonates had major hemorrhage. Intracranial hemorrhage ratio was 5.9 % and all of these patients were preterm. The incidence of hemorrhage increased with severity of thrombocytopenia. Severe thrombocytopenia was significantly higher in mechanically ventilated neonates. Platelet transfusion was given to 33% of neonates and the mortality rate was increased in these neonates. Thrombocytopenia improved in 93 % of patients and persisted in %4 of patients. Death occurred in 3% of neonates with thrombocytopenia but the causes of death in those patients were not attributable to thrombocytopenia.In conclusion, we found that the prevalance of thrombocytopenia decreased significantly during recent years and the distribution of causes of thrombocytopenia according to years changed in our neonatal service and neonatal intensive care unit. This study shows that rate of thrombocytopenia can be lowered by eliminating prevantable factors of thrombocytopenia in neonates and as a result, complications and risks of thrombocytopenia and platelet transfusion can be decreased.Key words: Neonates, thrombocytopenia