ISSN : 2146-3123
E-ISSN : 2146-3131

Neonatal Thrombocytopenia and the Role of the Platelet Mass Index in Platelet Transfusion in the Neonatal Intensive Care Unit
Tuba Kasap1, Şahin Takçı1, Burcu Erdoğan Irak1, Rüveyda Gümüşer1, Ergün Sönmezgöz1, Ali Gül1, Osman Demir2, Umut Safiye Şay Coşkun3
DOI : 10.4274/balkanmedj.galenos.2020.2019.7.47

Background: Neonatal thrombocytopenia (NT) is a common hematological abnormality that occurs in 20–35% of all newborns in the neonatal intensive care unit (NICU). Platelet transfusion (PT) is the only known treatment, however it is the critical point to identify neonates who are really at risk of bleeding and benefit from PT as it has also various potential harmful effects.
Aim: This study was performed to investigate the prevalence and risk factors of NT and its relationship to intraventricular hemorrhage (IVH) in the NICU, and further, to determine whether the use of platelet mass index (PMI) -based criteria could reduce the rate of PT.
Methods: This study was conducted retrospectively in the NICU of a tertiary university hospital. The medical records of neonates in the NICU with platelet counts <150 × 109/l between January 2013 and July 2016 were analyzed.
Results: During the study period, 2667 patients were admitted to the NICU and 395 (14%) had thrombocytopenia during hospitalization. The rate of IVH was 7.3%. Multiple logistic regression analysis showed that although lower platelet counts were associated with a higher IVH rate, the effects of respiratory distress syndrome (RDS), sepsis, and patent ductus arteriosus (PDA) were more prominent than the degree of thrombocytopenia. Thirty patients (7%) received PT, and these patients showed a significantly higher mortality rate than that of their non-PT counterparts (p < 0.001). In addition, it was found that the use of PMI-based criteria for PT in our patients would reduce the rate of PT by 9.5% (2/21).
Conclusion: NT is usually mild and often resolves without treatment. As PT is associated with an increased mortality rate, its risks and benefits should be weighed carefully. The use of PMI-based citeria may reduce PT rates in the NICU, but additional data from prospective studies are required.

Keywords : intraventricular hemorrhage, neonatal intensive care unit, newborn, platelet mass index, platelet transfusion, thrombocytopenia

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