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Microfluidics in Assessing Platelet Function
Published on: November 8, 2024
Platelet parameters and the association with morbidity and mortality in Preterm Infants
Po-Yu Hsieh1, Kai-Hsiang Hsu2, Ming-Chou Chiang2
1Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital Linkou Branch, Taoyuan, Taiwan.
Insights
Lower plateletcrit in preterm infants at birth indicates higher risk for early-onset sepsis, severe intraventricular hemorrhage, and mortality. These platelet parameters can predict neonatal morbidities.
Area of Science:
- Neonatal Medicine
- Hematology
- Immunology
Background:
- Platelets play a role in inflammation and immune responses, and are linked to cardiovascular diseases.
- Neonatal morbidities correlate with platelet activity, suggesting predictive potential for preterm infants.
- Platelet parameters may predict morbidities and mortality in preterm neonates.
Purpose of the Study:
- To assess initial platelet parameters in preterm neonates.
- To determine the association between platelet parameters and major neonatal morbidities and mortality.
Main Methods:
- Retrospective review of very preterm neonates (gestational age <32 weeks) admitted between June 2020 and May 2021.
- Analysis of platelet parameters: counts, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit at birth.
- Major morbidities included early-onset sepsis (EOS), severe intraventricular hemorrhage (IVH) grade ≥3, and early or overall mortality.
Main Results:
- Mean gestational age was 28.0 ± 2.4 weeks; mean plateletcrit was 0.24 ± 0.08%.
- Mean platelet volume (MPV) showed a weak negative correlation with gestational age and birth weight.
- Lower plateletcrit was significantly associated with EOS, severe IVH (grade ≥3), and early and overall mortality.
Conclusions:
- A lower plateletcrit within 24 hours of birth is linked to increased risk of EOS, severe IVH, and mortality in very preterm neonates.
- Initial plateletcrit measurements may serve as a predictive biomarker for adverse outcomes in preterm infants.
Background:
There is growing recognition of the role of platelets in inflammation and immune responses, and platelets have been associated with various cardiovascular diseases. It is also known that neonatal morbidities are related to overall platelet activity, and platelet parameters may have the potential to predict morbidities and mortality in preterm infants. This study aimed to assess the initial platelet parameters and the association with major morbidities and mortality in preterm neonates.
Methods:
We retrospectively reviewed data from very preterm neonates with a gestational age (GA) <32 weeks who were admitted between June 2020 and May 2021 for platelet parameters (counts, mean platelet volume (MPV), platelet distribution width (PDW) and plateletcrit (platelet counts x MPV/10000(%)) at birth. Major morbidities included early- onset sepsis (EOS) ≤3 days after birth, severe intraventricular hemorrhage (IVH) grade ≥3, and early or overall mortality.
Results:
A total of 197 very preterm neonates were studied. Their mean (±SD) GA was 28.0 ± 2.4 weeks, birth weight was 990 ± 293 g, platelet counts were 245 ± 81 x1000/μL, MPV was 10.0 ± 0.7 fl, PDW was 11.0 ± 1.6 fl, and plateletcrit was 0.24 ± 0.08%. MPV had a weak negative correlation with both GA (r = -0.234, p = 0.001) and BW (r = -0.343, p <0.001). A lower plateletcrit was associated with EOS (0.14 (0.04-0.22) % vs. 0.23 (0.19-0.30) %, p = 0.027), severe IVH ≤7 days after birth (0.18 (0.14-0.27) % vs. 0.23 (0.20-0.30) %, p = 0.022), and early and overall mortality (0.15 (0.20-0.30) % vs. 0.23 (0.20-0.30) %, p = 0.049; 0.20 ± 0.09 % vs. 0.25 ± 0.07 %, p = 0.008).
Conclusion:
A lower plateletcrit within 24 hours of birth was associated with EOS, severe IVH ≤7 days after birth, and first-week and overall mortality in very preterm neonates.
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