Early‐onset thrombocytopenia in near‐term and term infants with perinatal asphyxia. Issue 4 (29th October 2013)

• Record Type: Journal Article
• Authors: Boutaybi, N.; Steggerda, S. J.; Smits‐Wintjens, V. E. H. J.; van Zwet, E. W.; Walther, F. J.; Lopriore, E.
• Is Part Of: Vox sanguinis. Volume 106:Issue 4(2014)
• Page Start: 361
• Page End: 367
• Publication Date: 2013-10-29
• Subjects: Blood -- Periodicals; Blood -- Transfusion -- Periodicals; Immunohematology -- Periodicals; Immunopathology -- Periodicals; 615.39
• DOI: 10.1111/vox.12105
• Languages: English
• ISSNs: 0042-9007

Abstract

<abstract abstract-type="main" id="vox12105-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="vox12105-sec-0001" sec-type="section"> <title>Background</title> <p>Neonates after perinatal asphyxia are at increased risk of thrombocytopenia. The correlation between perinatal asphyxia and the risk and severity of early‐onset thrombocytopenia is not well known.</p> </sec> <sec id="vox12105-sec-0002" sec-type="section"> <title>Objective</title> <p>To estimate the incidence, severity and risk factors for early‐onset thrombocytopenia in neonates after perinatal asphyxia.</p> </sec> <sec id="vox12105-sec-0003" sec-type="section"> <title>Methods</title> <p>We included all newborns (gestational age ≥ 36 weeks) admitted to our neonatal nursery due to perinatal asphyxia in this retrospective study. We collected platelet counts that were obtained within the first 48 h of life to estimate the incidence and severity of early‐onset thrombocytopenia.</p> </sec> <sec id="vox12105-sec-0004" sec-type="section"> <title>Results</title> <p>A total number of 171 neonates with perinatal asphyxia were included in the study. The incidence of early‐onset thrombocytopenia (platelet count < 150 × 10<sup>9</sup>/l) was 51% (87/171). Several factors were associated with increased risk of early‐onset thrombocytopenia, including prolonged prothrombin time (PT) [odds ratio (OR) 1·18, 95% confidence interval (CI) 1·08–1·30, <italic>P</italic> < 0·01], prolonged activated partial thromboplastin time (APTT) (OR 1·07, 95% CI 1·03–1·11, <italic>P</italic> < 0·01), low Apgar score at 10 min (OR 1·25, 95% CI 1·08–1·45, <italic>P</italic> < 0·01) and high serum lactate (OR 1·12, 95% CI 1·06–1·19, <italic>P</italic> < 0·01). After multiple logistic regression analysis, we found an independent association between early‐onset thrombocytopenia and prolonged PT (OR 1·15, 95% CI 1·00–1·33, <italic>P</italic> = 0·045) and higher lactate level (OR 1·15, 95% CI 1·03–1·28, <italic>P</italic> = 0·01).</p> </sec> <sec id="vox12105-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Early‐onset thrombocytopenia occurs frequently in neonates after perinatal asphyxia and is independently associated with PT and lactate level.</p> </sec> </abstract>