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Thrombocytopenia at birth is a predictor of cholestasis in infants with small for gestational age

Hidehiko Maruyama1, Makoto Nakamura, Naohiro Yonemoto

  • 1Department of Neonatology, National Hospital Organization Okayama Medical Center, Okayama 701-1192, Japan. maruyamahidehiko@gmail.com

Acta Medica Okayama
|August 24, 2013
PubMed

Insights

Thrombocytopenia, or low platelets, at birth can predict cholestasis (liver disease) in infants born small for gestational age. This finding aids in early detection for very-low-birth-weight infants.

Area of Science:

  • Neonatal Medicine
  • Pediatric Gastroenterology
  • Hematology

Background:

  • Infants born small for gestational age (SGA) often experience cholestasis and thrombocytopenia.
  • Hepatic underdevelopment in SGA infants leads to reduced thrombopoietin and increased cholestasis risk.

Purpose of the Study:

  • To investigate if thrombocytopenia at birth can predict cholestasis in very-low-birth-weight infants (VLBWIs) with SGA.
  • To establish a predictive platelet count threshold for cholestasis in this vulnerable population.

Main Methods:

  • Retrospective cohort study of VLBWIs with SGA.
  • Receiver operating characteristic (ROC) analysis to determine the platelet cutoff value.
  • Multivariate logistic regression and survival analysis to assess predictive accuracy.

Main Results:

  • A platelet count cutoff of 88×10(3) cells/μl was identified as predictive of cholestasis.
  • This cutoff showed a significant adjusted odds ratio (OR) of 10.52 (p=0.003) and hazard ratio (HR) of 7.76 (p=0.0006).

Conclusions:

  • Thrombocytopenia at birth is a valuable predictor of cholestasis in VLBWIs with SGA.
  • Early identification of thrombocytopenia can facilitate timely intervention for cholestasis.

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