Prospective, observational study of outcomes in neonates with severe thrombocytopenia

Stanworth, Simon J., Clarke, Paul, Watts, Tim, Ballard, Sally, Choo, Louise, Morris, Tim, Murphy, Mike F. and Roberts, Irene (2009) Prospective, observational study of outcomes in neonates with severe thrombocytopenia. Pediatrics, 124 (5). e826-e834. ISSN 0031-4005

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Abstract

OBJECTIVE: A cross-sectional, observational study of outcomes for neonates with severe neonatal thrombocytopenia (SNT; platelet count of <60 × 109 platelets per L) was performed to examine hemorrhage and use of platelet transfusions. METHODS: Neonates who were admitted to 7 NICUs and developed SNT were enrolled for daily data collection. RESULTS: Among 3652 neonatal admissions, 194 neonates (5%) developed SNT. The median gestational age of 169 enrolled neonates was 27 weeks (interquartile range [IQR]: 24 -32 weeks), and the median birth weight was 822 g (IQR: 670 -1300 g). Platelet count nadirs were <20 × 109, 20 to 39 × 109, and 40 to 59 × 109 platelets per L for 58 (34%), 64 (39%), and 47 (28%) of all enrolled infants, respectively. During the study, 31 infants (18%) had no recorded hemorrhage, 123 (73%) developed minor hemorrhage, and 15 (9%) developed major hemorrhage. Thirteen (87%) of 15 episodes of major hemorrhage occurred in neonates with gestational ages of <28 weeks. Platelet transfusions (n = 415) were administered to 116 infants (69%); for 338 (81%) transfusions, the main recorded reason was low platelet count. Transfusions increased the platelet count from a median of 27 × 109 platelets per L (IQR: 19-36 × 109 platelets per L) to 79 × 109 platelets per L (IQR: 47.5-127 × 109 platelets per L). CONCLUSIONS: Although one third of neonates enrolled in this study developed thrombocytopenia of <20 × 109 platelets per L, 91% did not develop major hemorrhage. Most platelet transfusions were given to neonates with thrombocytopenia with no bleeding or minor bleeding only.

Item Type: Article
Uncontrolled Keywords: hemorrhage,neonate,platelet transfusion,thrombocytopenia,pediatrics, perinatology, and child health ,/dk/atira/pure/subjectarea/asjc/2700/2735
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Depositing User: LivePure Connector
Date Deposited: 19 Oct 2020 23:59
Last Modified: 24 Nov 2020 01:45
URI: https://ueaeprints.uea.ac.uk/id/eprint/77341
DOI: 10.1542/peds.2009-0332

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