scholarly journals Risk Factors For Severity Of Thrombocytopenia In Full Term Infants: A Single Center Study

2020 ◽  
Author(s):  
Amira M Saber ◽  
Shereen P Aziz ◽  
Al Zahraa E Almasry ◽  
Ramadan A Mahmoud

Abstract Background: Neonatal thrombocytopenia (NT) (platelet count <150 x 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, risk factors, and outcomes of severe NT in full term (FT) infants.Methods: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.Results: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P=0.001) and had higher rates of mortality (P=0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P=0.001).Conclusion: Severe NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with original disease of the babies.

2021 ◽  
Vol 47 (1) ◽  
Author(s):  
Amira M. Saber ◽  
Shereen P. Aziz ◽  
Al Zahraa E. Almasry ◽  
Ramadan A. Mahmoud

Abstract Background Neonatal thrombocytopenia (NT) (platelet count < 150 × 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, risk factors, and outcomes of severe NT in full term (FT) infants. Methods During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded. Results In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P = 0.001) and had higher rates of mortality (P = 0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P = 0.001). Conclusion Severe NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with original disease of the babies.


2020 ◽  
Author(s):  
Amira M Saber ◽  
Shereen P Aziz ◽  
Al Zahraa E Almasry ◽  
Ramadan A Mahmoud

Abstract Background: Neonatal thrombocytopenia (NT) (platelet count <150 x 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, risk factors, and outcomes of severe NT in full term (FT) infants.Methods: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.Results: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P=0.001) and had higher rates of mortality (P=0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P=0.001).Conclusion: Severe NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with original disease of the babies.


2020 ◽  
Author(s):  
Amira M Saber ◽  
Shereen P Aziz ◽  
Al Zahraa E Almasry ◽  
Ramadan A Mahmoud

Abstract Background: Neonatal thrombocytopenia (NT) (platelet count <150 x 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, rick factors, and outcomes of severe NT in full term (FT) infants.Methods: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.Results: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P=0.001) and had higher rates of mortality (P=0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P=0.001).Conclusion: Thrombocytopenia is a frequent challenge between neonatologists. The most common causes of NT in FT infants were neonatal sepsis, followed by postoperative state. Furthermore, when severe NT compared to mild/moderate NT, associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions, and had increased mortality. Further research is needed to explain which of these complications related to severity of thrombocytopenia or were associated with the bad general condition of these patients due to their original disease.


2020 ◽  
Author(s):  
Amira M Saber ◽  
Shereen P Aziz ◽  
Al Zahraa E Almasry ◽  
Ramadan A Mahmoud

Abstract Background Neonatal thrombocytopenia (NT) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, rick factors and outcomes of severe NT in full term (FT) infants. Method: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases were recorded. Furthermore, neonatal data such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, blood count and outcomes for neonates admitted to the NICU were recorded. Results In total, 55 FT infants with NT met the inclusion criteria. In all, 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 37.03%), followed by a postoperative state (5 cases, 9.25%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT, when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P = 0.001), needed more platelet transfusions (P = 0.001) and had higher rates of mortality (P = 0.001). Conclusion Severe NT occurred in 52.73% of cases. The most common cause of NT was neonatal sepsis, followed by a postoperative state. Furthermore, severe NT, when compared to mild/moderate NT associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions and had increased mortality.


2020 ◽  
Author(s):  
Amira M Saber ◽  
Shereen P Aziz ◽  
Al Zahraa E Almasry ◽  
Ramadan A Mahmoud

Abstract Background: Neonatal thrombocytopenia (NT) (platelet count <150 x 109/L) is a common finding in the neonatal intensive care unit (NICU). The main aim of this study was to assess the prevalence, rick factors, and outcomes of severe NT in full term (FT) infants.Methods: During the study period, all FT infants who met the inclusion criteria for NT on two occasions were included. Maternal data, such as maternal age, weight, gestational age, mode of delivery, and history of systemic diseases, including diabetes mellitus, pre-eclampsia, systemic lupus erythematosus, and immune thrombocytopenic purpura, were recorded. Furthermore, neonatal data, such as gender, neonatal weight, causes/duration of admission, types of respiratory support used, complete blood count measurements, and outcomes for neonates admitted to the NICU, were recorded.Results: In total, 55 FT infants with NT met the inclusion criteria, and 29 (52.73%) cases had severe NT. The most common cause of NT was neonatal sepsis (20 cases, 36.35%), followed by a postoperative state (5 cases, 9.09%). Moreover, in cases of positive blood cultures, the most commonly isolated organism was Escherichia coli (6 cases, 10.90%), followed by Klebsiella (5 cases, 9.09%). Cases of severe NT needed more platelet transfusions (P=0.001) and had higher rates of mortality (P=0.001) when compared to cases of mild/moderate NT associated with signs of bleeding and pulmonary/intraventricular hemorrhage (IVH) (P=0.001).Conclusion: Severe NT occurred in 52.73% of cases. The most common cause of NT was neonatal sepsis, followed by a postoperative state. Furthermore, severe NT, when compared to mild/moderate NT associated with signs of bleeding and pulmonary/IVH, needed more platelet transfusions and had increased mortality.


Author(s):  
Kelley M. Sonney ◽  
Michael G. Guindon ◽  
James K. Aden ◽  
Caitlin M. Drumm

Objective This study aimed to examine the epidemiology of antibiotic exposure and early onset sepsis (EOS) in late preterm and term infants born via cesarean section with rupture of membranes less than 10 minutes. Study design Retrospective review of 1,187 late preterm and term infants born at Brooke Army Medical Center between January 1, 2012 and August 29, 2019. Subjects were assessed for factors related to antibiotic treatment. Statistical analysis was performed to compare infants treated with antibiotics versus observation. Result An early blood culture was obtained from 234 (19.7%) infants; 170 (14.3%) were treated with antibiotics. Infants treated with antibiotics were significantly younger (p < 0.0001), smaller (p < 0.0001), more often diagnosed with respiratory distress (p < 0.0001), and were more frequently admitted to the neonatal intensive care unit (p < 0.0001). There were no cases of culture proven EOS. Conclusion Although this population lacks risk factors for the development of EOS, a significant percentage was treated with antibiotics. This population may benefit from future antibiotic stewardship efforts. Key Points


Hematology ◽  
2012 ◽  
Vol 2012 (1) ◽  
pp. 506-511 ◽  
Author(s):  
Martha Sola-Visner

Abstract Thrombocytopenia is a common problem among sick neonates admitted to the neonatal intensive care unit. Frequently, platelet transfusions are given to thrombocytopenic infants in an attempt to decrease the incidence or severity of hemorrhage, which is often intracranial. Whereas there is very limited evidence to guide platelet transfusion practices in this population, preterm infants in the first week of life (the highest risk period for bleeding) are nearly universally transfused at higher platelet counts than older infants or children. To a large extent, this practice has been influenced by the observation that neonatal platelets are hyporeactive in response to multiple agonists in vitro, although full-term infants exhibit normal to increased primary hemostasis. This apparently paradoxical finding is due to factors in the neonatal blood that enhance the platelet-vessel wall interaction and counteract the platelet hyporeactivity. Relatively few studies have evaluated the platelet function and primary hemostasis of preterm infants, the subset of neonates at highest risk of bleeding and those most frequently transfused. Current understanding of platelet production and function in preterm and full-term neonates, how these factors affect their response to thrombocytopenia and their primary hemostasis, and the implications of these developmental differences to transfusion medicine are reviewed herein.


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