Immediate and short-term outcomes, including mortality and morbidity, of thrombocytopenia among neonates

Abstract

Objectives: The primary objective of this research study was to assess the immediate and short-term outcomes, including mortality and morbidity, of thrombocytopenia among neonates. Additionally, the study aimed to identify the maternal and fetal risk factors associated with thrombocytopenia in neonates. Methods: This was a prospective observational study conducted in the Department of Paediatrics of a tertiary healthcare facility in northern India between January 2018 to December 2018. The study included all the inborn neonatal intensive care unit (NICU) admissions during the study period; a baseline investigation done and followed up for 3 months – neonates lost to follow up or expired were excluded from three-month data. Results: The prevalence of thrombocytopenia (<150,000/μL) in the present study was 33.3% – of which, 60.0% admissions had mild to moderate thrombocytopenia (50,00/ μL to 150,000/μL) and 40.0% had severe thrombocytopenia (<50,000/μL). Maternal PIH, age at presentation, IUGR, septicaemia, and assisted ventilation were significantly associated with severe thrombocytopenia in neonates (p<0.05). Other maternal factors such as gestational diabetes mellitus, Rh incompatibility, premature rupture of membrane, antepartum haemorrhage, place, and mode of delivery were not significantly associated with thrombocytopenia. Mucosal bleed, NEC, intracranial haemorrhage, petechiae and/or purpura were significant complications associated with severe thrombocytopenia in neonates. The mortality rates in the present study were highest among neonates with severe thrombocytopenia (42.5%), followed by neonates with mild to moderate thrombocytopenia (11.7%) and no thrombocytopenia (2.0%) in that order. Conclusion: Timely intervention and comprehensive care are crucial to improve outcomes and reduce the risks associated with thrombocytopenia in neonates.