The study of thrombocytopenia in sick neonates

To determine the number of cases and manifestations of thrombocytopenia in sick neonates.

An observational study.

The study was conducted at Neonatal Intensive Care Unit (NICU) of the Paediatric Department, Jinnah Hospital, Lahore from September 1997 to February 1998.

A total of 365 neonates from 0-28 days of age admitted with different clinical problems irrespective of birth weight and gestational age were evaluated for thrombocytopenia. These neonates were categorized into five different groups (A-E), which were of neonatal infections, asphyxia neonatorum, preterm and smallness for gestational age, jaundice and miscellaneous respectively.

Out of 365 cases, 88 were found to have thrombocytopenia (platelet counts < 150,000 per mm3) which was 24.1% of the total. In group A (neonatal infections), out of 152 neonates, 62 had low platelet counts (40.78%). In group B (neonatal asphyxia), out of 90 only 11 had thrombocytopenia (12.2%). In group C (preterm and small for gestational age), out of 60 cases only 9 had thrombocytopenia. In group D (jaundice), all 33 cases had normal platelet counts. In group E (miscellaneous), out of 30 cases only 6 had thrombocytopenia. The common manifestations in thrombocytopenic babies were petechiae and bruises followed by gastrointestinal hemorrhages. The percentage of manifest thrombocytopenia cases was 56.8% and of occult thrombocytopenia 43.1%.

The leading causes of thrombocytopenia in sick neonates are infections, asphyxia, complicated pre-maturity and smallness for gestational age. Apart from the platelet counts the bleeding mainfestations also depend upon the underlying ailments.