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Published on: June 29, 2013
Thrombocytopenia in preterm infants with intrauterine growth restriction
Hidehiko Maruyama1, Masako Shinozuka, Yo-Ichi Kondoh
1Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. hidemaru@md.okayama-u.ac.jp
Insights
Thrombocytopenia in sick preterm infants may indicate severe intrauterine growth restriction (IUGR) due to chronic hypoxia. This finding highlights the importance of monitoring platelet counts in these vulnerable newborns.
Area of Science:
- Neonatalogy
- Perinatal Medicine
- Pediatric Hematology
Background:
- Sick preterm infants frequently exhibit thrombocytopenia (low platelet count) at birth.
- Thrombocytopenia is often linked to intrauterine growth restriction (IUGR), defined as birth weight below the 10th percentile.
- The exact causes and significance of thrombocytopenia in IUGR remain poorly understood.
Purpose of the Study:
- To investigate the characteristics of preterm infants with IUGR and thrombocytopenia.
- To explore the relationship between thrombocytopenia and the severity of IUGR in preterm neonates.
Main Methods:
- A retrospective study of 27 singleton Japanese preterm infants born between 2002 and 2007 with IUGR.
- Exclusion criteria included malformations, chromosomal abnormalities, alloimmune thrombocytopenia, sepsis, and maternal aspirin use.
- Infants were divided into two groups: Group A (n=8) with thrombocytopenia within 72 hours of birth, and Group B (n=19) without thrombocytopenia.
Main Results:
- Group A infants were significantly smaller with lower birth weights and head circumferences compared to Group B.
- Abnormal umbilical artery (UA)-pulsatility index (PI) and middle cerebral artery-PI were observed in Group A.
- Group A infants showed significant differences in UA-pH, UA-pO2, and UA-pCO2, indicating hypoxia at birth.
Conclusions:
- Preterm infants with thrombocytopenia and IUGR exhibited characteristics suggestive of more severe growth restriction.
- The findings suggest that thrombocytopenia in this population may be a marker of chronic intrauterine hypoxia.
- Monitoring thrombocytopenia could be important for assessing chronic hypoxia in utero for IUGR infants.
Abstract:
Sick preterm infants often have thrombocytopenia at birth, and this is often associated with intrauterine growth restriction (IUGR), or birth weights less than the 10th percentile. The pathogenesis of the thrombocytopenia and its importance in IUGR are still unclear. We studied the characteristics of preterm IUGR infants with thrombocytopenia. Twenty-seven singleton Japanese preterm IUGR infants were born between January 2002 and June 2007 at Okayama University Hospital. Infants with malformation, chromosomal abnormalities, alloimmune thrombocytopenia, sepsis, and maternal aspirin ingestion were excluded. The infants were divided into group A (n=8), which had thrombocytopenia within 72 h after birth, and group B (n=19), which did not. There were significant differences in birth weight, head circumference, umbilical artery (UA)-pulsatility index (PI), middle cerebral artery-PI, UA-pH, UA-pO2, and UA-pCO2. The infants in group A were smaller, had abnormal blood flow patterns, and were hypoxic at birth. We speculate that the infants with thrombocytopenia were more severely growth-restricted by chronic hypoxia. Thrombocytopenia is an important parameter for chronic hypoxia in the uterine.
