Study of risk factors of neonatal thrombocytopenia

Background: Neonatal thrombocytopenia (platelet count < 1.5 lac/µl) is the commonest haematological abnormality encountered in neonatal intensive care unit (NICU). Thrombocytopenia if not detected can result in devastating complications. Determining the risk factors of thrombocytopenia enables us to prevent the inevitable and irreversible complications. The present study highlights the pattern, severity and risk factors of neonatal thrombocytopenia in our hospital.Methods: Prospective observational study was conducted on 200 neonates with thrombocytopenia admitted in NICU of our hospital. Maternal and neonatal risk factors were recorded. Neonates were grouped based on the severity of thrombocytopenia. The risk factors were compared with severity of thrombocytopenia.Results: 200 neonates with thrombocytopenia were divided into three groups based on severity of thrombocytopenia. 81% of babies had moderate to severe thrombocytopenia. The most common maternal predisposing factors were pregnancy induced hypertension (PIH), premature rupture of membranes (PROM) and anemia.62.5% babies were low birth weight babies and they had severe thrombocytopenia. 56% babies had late onset neonatal thrombocytopenia and 44% had early onset thrombocytopenia. The most common neonatal risk factors were sepsis in 48.5% babies and birth asphyxia in 20% babies.Conclusions: The severity of neonatal thrombocytopenia in our NICU was moderate to severe type. PIH, PROM and anemia were the commonest maternal risk factors. Preterm and low birth weight babies had severe thrombocytopenia. Sepsis and birth asphyxia were the commonest neonatal risk factors. Birth asphyxia was associated with early onset neonatal thrombocytopenia and sepsis was associated with late onset thrombocytopenia. Severe thrombocytopenia can be used as a prognostic indicator in sick neonates.

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Presentation and outcomes of early and late onset neonatal sepsis in a Nigerian Hospital

African Health Sciences ◽

10.4314/ahs.v19i3.12 ◽

2019 ◽

Vol 19 (3) ◽

pp. 2390-2399

Author(s):

Ezra Ogundare ◽

Akinyemi Akintayo ◽

Theophilus Aladekomo ◽

Lateef Adeyemi ◽

Tinuade Ogunlesi ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Sepsis ◽

Early Onset ◽

Life Support ◽

Late Onset ◽

Significant Risk ◽

Birth Asphyxia ◽

Diffusion Method

Background: Neonatal Sepsis remains a major cause of morbidity and mortality in neonates despite great advances in antimicrobial therapy and life support measures.Objectives: To compare the aetiology, risk factors, presentation and outcomes of care between early onset neonatal sepsis (EOS) and late onset neonatal sepsis (LOS).Methods: Bacterial isolates were identified using blood cultures and antibiotic susceptibility testing was done using disc diffusion method. The risk factors, clinical presentation, laboratory findings and neonatal outcomes of the babies with EOS were compared with LOS. Statistical significance was set at P <0.05.Results: Neonatal Sepsis was responsible for 16% of Special Care Baby Unit (SCBU) admissions. Of the 72 babies with sepsis, 56 (77.8%) had EOS as against 16 (22.2%) who had late-onset sepsis. Low birth weight (p=0.01) and perinatal asphyxia (p=0.01) were significantly associated with EOS while for LOS, delivery outside the health facility (p=0.01) was the only significant risk factor. Respiratory distress was more significantly observed in EOS (p = 0.01). Neonatal deaths occurred in 32% of babies with EOS while all babies with culture positive LOS survived.Conclusion: Early onset neonatal sepsis is associated with high likelihood of neonatal mortality. Unsupervised delivery, birth asphyxia and low birth weight are risk factors associated with neonatal sepsis. Efforts to ensure supervised hospital delivery and improvement in neonatal resuscitation may reduce the incidence of neonatal sepsis and its attendant complications.Keywords: Onset neonatal , Nigerian Hospital.

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Risk Factors and Outcome of Neonatal Thrombocytopenia

Journal of Rawalpindi Medical College ◽

10.37939/jrmc.v24i3.1331 ◽

2020 ◽

Vol 24 (3) ◽

pp. 229-234

Author(s):

Hira Arif ◽

Nadeem Ikram ◽

Shangraf Riaz ◽

Asma Nafisa

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Neonatal Intensive Care ◽

Birth Asphyxia ◽

P Value ◽

Maternal Risk ◽

Significant Difference ◽

Neonatal Thrombocytopenia ◽

A Prospective Study

Introduction: About 30% of neonates develop thrombocytopenia during hospital admission. Inevitable and irreversible complications can be prevented by determining the risk factors of neonatal thrombocytopenia. The present study was undertaken to determine the risk factors and outcome of neonatal thrombocytopenia in neonates admitted to Neonatal Intensive Care Unit Benazir Bhutto Hospital Rawalpindi. Materials and Methods: A prospective study was conducted to evaluate the risk factors for neonatal thrombocytopenia (NT) in 160 neonates. Neonatal and maternal risk factors were recorded and neonates were categorized into three groups based on the severity of thrombocytopenia. Results: A higher percentage of the neonates 89 (55.6%) were male. The majority (61.9%) had moderate neonatal thrombocytopenia while 21.9% had severe neonatal thrombocytopenia. A highly significant difference was observed for the distribution of gestational age, platelet count, birth weight, and age at admission (for all p-value ≥0.0001) among different groups. Multivariate logistic regression revealed a significant independent association of prematurity, birth asphyxia, and low birth weight with neonatal thrombocytopenia. Conclusion: Prematurity, low birth weight, and birth asphyxia were the significant causes of Neonatal thrombocytopenia. The mortality rate increased significantly with the severity of thrombocytopenia.

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Forecasting the possibility of neonatal early onset sepsis based on perinatal risk factors

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20202611 ◽

2020 ◽

Vol 7 (7) ◽

pp. 1534

Author(s):

Kiran C. Pankaj ◽

Sristi Ganguly ◽

Manas R. Upadhyay

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Birth Weight ◽

Blood Culture ◽

Low Birth Weight ◽

Early Onset ◽

Birth Asphyxia ◽

Perinatal Risk Factors ◽

Perinatal Risk ◽

Early Onset Sepsis

Background: Neonatal sepsis remains a leading cause of neonatal mortality and morbidity, diagnosis of which remains difficult due to variable presentations. With the increasing threat of antimicrobial resistance, it is important to identify perinatal risk factors which are associated with higher incidence of definite sepsis, to initiate empirical antibiotics, while awaiting blood culture reports.Methods: This was hospital based cross-sectional study done in SVPPGIP, Cuttack, Odisha during January 2019 to April 2019, enrolling all neonates ≥37 weeks gestation and aged less than 72 hours, with suspected early onset sepsis. Neonates with TORCH infections, congenital anomalies, syndromic baby or with surgical conditions were excluded. After obtaining informed consent, blood culture was sent for all and their perinatal risk factors noted. Blood culture positive newborns were considered to have definite sepsis. Data was analysed with Chi-square test and percentages, using SPSS 18.Results: Among the 200 cases, incidence of definite sepsis was 26%. The most common risk factor was low birth weight and birth asphyxia. Majority (67%) had single or lesser risk factor and number of risk factors was significantly associated with definite sepsis. A significant association was seen between blood culture positivity with low birth weight (p=0.003), foul smelling liquor (p= 0.025), birth asphyxia (p 0.018) and premature rupture of membranes (p= 0.016). The combination of maternal fever and unclean vaginal examination was also significantly associated with the same.Conclusions: Protocols for initiating empiric antibiotics need to be formulated, taking into account the significant risk factors, in resource limited settings, to avoid resource and time wastage.

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Neonatal Thrombocytopenia: Its associated risk factors and outcome in NICU in a tertiary hospital in Nepal

Journal of College of Medical Sciences-Nepal ◽

10.3126/jcmsn.v14i2.19322 ◽

2018 ◽

Vol 14 (2) ◽

pp. 65-68

Author(s):

Bishow Bandhu Bagale ◽

Anita Bhandari

Keyword(s):

Risk Factors ◽

Neonatal Intensive Care ◽

Platelet Transfusion ◽

Late Onset ◽

Tertiary Hospital ◽

Severe Thrombocytopenia ◽

Maternal Risk Factors ◽

Maternal Risk ◽

Neonatal Thrombocytopenia ◽

Neonatal Risk Factors

ABSTRACTBackground: Thrombocytopenia is a frequently encountered hematological abnormality in Neonatal Intensive Care Unit (NICU). There are various maternal and neonatal risk factors associated and the incidence varies greatly depending upon the population studies. This study was performed on neonates admitted in Bharatpur Hospital NICU.Materials & Methods: In this retrospective study, 412 neonates who were admitted in NICU from November 2016 to October 2017 were included in the study. Frequency of thrombocytopenia was determined along with associated maternal and neonatal risk factors. Maternal risk factors like Pregnancy induced hypertension (PIH), Diabetes, Eclampsia, drug use and neonatal risk factors like sepsis, asphyxia, intrauterine growth retardation (IUGR), prematurity were analyzed. Requirement of platelet transfusion and the outcome were also evaluated. Results: Of the 412 neonates included, 74 had thrombocytopenia which comprised approximately 18% neonates admitted in NICU. Early onset thrombocytopenia occurring within 72 hrs comprised 91.8% while late onset thrombocytopenia occurring after 72 hrs comprised 8.2% of total thrombocytopenia. 58.1% (43) were mild , 29.7% (22) moderate and 12.2% (9) severe thrombocytopenia. The major neonatal risk factors were sepsis, asphyxia, IUGR and prematurity while gestational diabetes and PIH were maternal risk factors contributing to neonatal thrombocytopenia. Only 4.05% received platelet transfusion. 77.03% of the neonates recovered and were discharged while 12.16% neonates were referred to other centres and 5.40% neonates died.Conclusion: Neonatal thrombocytopenia accounted for 18% of neonates which were admitted in the NICU. Significant neonatal risk factors were asphyxia and sepsis and maternal risk factors were PIH and diabetes. Majority did not require platelet transfusion and outcome was also good.

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Prevalence and predictors of adverse outcomes in neonatal seizures

Journal of Neonatal-Perinatal Medicine ◽

10.3233/npm-200499 ◽

2021 ◽

pp. 1-7

Author(s):

K. Famra ◽

P. Barta ◽

A. Aggarwal ◽

B.D. Banerjee

Keyword(s):

Birth Weight ◽

Low Birth Weight ◽

Very Low Birth Weight ◽

Birth Asphyxia ◽

Adverse Outcomes ◽

Neonatal Seizures ◽

Clinical Practices ◽

Inborn Errors ◽

Mortality And Morbidity ◽

Low Birth Weight Babies

OBJECTIVES: Neonatal seizures are significant cause of neonatal mortality and morbidity. Current study was planned to study prevalence of adverse outcomes in neonatal seizures and identify its predictors. METHODS: This observational descriptive study was carried out on 220 neonates with seizures. Neonates who succumbed to illness/ death before investigations, or whose maternal records were incomplete were excluded. Blood sugar, serum calcium, serum electrolytes, and USG skull were done in all patients. CT scan, MRI and inborn errors of metabolism profile were done as and when indicated. Adverse outcomes were defined as death, phenobarbitone non responders, or abnormal examination at discharge. Antenatal, perinatal and neonatal predictors of adverse outcomes in neonatal seizures were evaluated. RESULTS: Out of 220 neonates with seizures 76(34.5%) had adverse outcomes. Very low birth weight babies (≤1500 gm) [OR 1.27(CI 0.57–2.84)], microcephaly [OR 5.93 (CI 0.55–64.41)], Apgar score≤3 at 5 minutes [OR 11.28(CI 14.18–30.45)], seizure onset within 24 hours [OR 5.99(CI 12.43–14.78)], meningitis [OR 2.63(CI 0.08–6.39)], septicemia [OR1.22(CI 0.45–3.31)] and abnormal cranial USG [OR 7.95(CI 12.61–24.22)] were significant predictors of adverse outcomes in neonates with seizures. CONCLUSION: Prematurity, very low birth weight, birth asphyxia, meningitis, septicemia and abnormal USG could predict adverse outcomes in neonatal seizures. Improved antenatal and neonatal clinical practices may help reduce adverse outcomes in these patients.

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A retrospective study of predisposing factors and outcome of persistant pulmonary hypertension among newborns at rural tertiary care centre

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20205512 ◽

2020 ◽

Vol 8 (1) ◽

pp. 92

Author(s):

B. C. Yelamali ◽

Gangadhar S. Mirji ◽

Mirnalini Rajput

Keyword(s):

Risk Factors ◽

Pulmonary Hypertension ◽

Retrospective Study ◽

Birth Weight ◽

Low Birth Weight ◽

Birth Asphyxia ◽

Male Gender ◽

Predisposing Factors ◽

Positive Pressure ◽

Increased Risk

Background: Persistent pulmonary hypertension in newborns (PPHN) remains a significant cause of perinatal morbidity and mortality. Early recognition of factors that increase the risk of PPHN is of great importance in either to prevent or to treat PPHN optimally. Aim was to study the neonatal predisposing factors, profile and outcome of PPHN.Methods: This retrospective study was conducted in level III neonatal care unit, a rural referral centre of North Karnataka, India from January 2018 to April 2020.Results: During the study period a total of 50 infants with PPHN were identified with the incidence of 5.43/1000 live births. Mean gestation age (±SD) was 38.28±2.49 weeks and mean birth weight (±SD) was 2624±512 gm. The most noted risk factors were meconium aspiration syndrome (42%), birth asphyxia (16%), RDS (10%), positive pressure ventilation at birth (52%) and male gender (62%). Out of 50 infants with PPHN, high mortality was seen in low birth weight babies (66.6%). Use of sildenafil showed increased mortality (56.2%) whereas use of surfactant scored better with decreased mortality of 42.8%.Conclusions: Major risk factors for PPHN are MAS, birth asphyxia, RDS and low birth weight. Poor prognosis is seen in male gender, prematurity and CDH with increased risk of mortality. The use of systemic pulmonary vasodilators can be considered with caution and use of surfactant has a role in management of PPHN.

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Clinical profile and outcome of early onset sepsis in high risk very low birth weight neonates

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20180480 ◽

2018 ◽

Vol 5 (2) ◽

pp. 389 ◽

Cited By ~ 1

Author(s):

Omprakash S. Shukla ◽

Aditi Rawat

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Blood Culture ◽

Low Birth Weight ◽

Neonatal Sepsis ◽

Early Onset ◽

Very Low Birth Weight ◽

Gram Negative ◽

Early Onset Sepsis ◽

Culture Positive

Background: Neonatal sepsis is one of the main causes of mortality and morbidity, especially in very low birth weight neonates (birth weight <1499 grams) despite the progress in hygiene, introduction of new and potent antimicrobial agents for treatment and advanced measures for diagnosis. The aim of the study was to find correlation of clinical features and risk factors of neonatal sepsis in culture positive cases.Methods: A cross- sectional study was carried out in one hundred neonates with risk factors of septicemia after obtaining informed consent. Blood culture was done using Bactec Peds Plus/F Culture as a gold standard to diagnose septicaemia. Correlation of risk factors, clinical features with laboratory findings was obtained by using chi-square test. p-value of less than 0.05 was considered as significant.Results: Out of 100 neonates with suspected sepsis, BACTEC culture proven sepsis was seen in 40% cases. Gram negative sepsis was seen in 62.5% cases. The most common bacteria for early onset sepsis were Klebsiella, Pseudomonas and MRSA contributing 17% each to the bacteriological profile. The most common predisposing factor and clinical feature in culture positive cases were Premature rupture of membrane >24 hours (67%) and bleeding/petechia/pupura (72%) respectively. The major cause of mortality was pulmonary hemorrhage.Conclusions: Gram negative organism were more common and associated with higher mortality. Blood culture positivity increases with increase in number of risk factors in neonatal septicemia. A detailed history and thorough clinical examination is vital for early recognition of sepsis.

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Maternal Risk Factors, Clinical Profile and Short-Term Outcome of Pre-Term Low Birth Weight Babies

KYAMC Journal ◽

10.3329/kyamcj.v11i2.48419 ◽

2020 ◽

Vol 11 (2) ◽

pp. 77-82

Author(s):

Mosammat Afroza Jinnat ◽

Shafi Ahmed ◽

Sirajum Monira ◽

Muhammad Mozammel Haque ◽

Mashura Musharraf ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Low Birth Weight ◽

Maternal Risk Factors ◽

Short Term ◽

Term Outcome ◽

Maternal Risk ◽

Short Term Outcome ◽

Low Birth Weight Babies ◽

Neonatal Ward

Background: Preterm Low Birth Weight babies carry relatively higher risk of perinatal and neonatal mortality, retarded growth and development subsequently. In this study, some maternal risk factors were investigated as it seems to be important to study these factors on regional basis. Objective: To find out the maternal risk factors, clinical profile and short term outcome of pre-term low birth weight neonates by gestational age, birth weight, Occipitofrontal Circumference, length, different presentation (asphyxia, hypothermia, feeding difficulties, signs of infection) on admission and the morbidity and mortality of preterm LBW. Materials and Methods: A descriptive type of cross sectional study was done in neonatal ward of Jalalabad Ragib Rabeya Medical College Hospital, Sylhet from May, 2015 to April, 2016. Hundred cases were selected from neonatal ward and 100 controls were selected from obstetrics ward. Results: Among 100 pre-term LBW neonates, 52 were male and 48 were female. Only 22% mother took regular antenatal check up in case group and 55% in control group. Mean gestational age of neonates were 33.3±2.1 weeks. Important risk factors were primi parity (58% in cases vs 34% in control), hypertension (19% vs 5%), pre-eclampsia (26% vs 12%), prolonged rupture of membrane (33% vs 7%), APH (22% vs 0%), acute infection (8% vs 1%), multiple birth (17% vs 2%). Common clinical presentations were prematurity and LBW. Commonest morbidity was feeding problem (70%). The overall survival rate was 87%. Most common cause of death was septicemia (30%). Conclusion: all the identified risk factors were significantly higher in pre-term LBW babies than those of control. KYAMC Journal Vol. 11, No.-2, July 2020, Page 77-82

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