PROGNOSTIC SIGNIFICANCE OF EARLY PLATELET COUNT DECLINE IN PRETERM NEWBORNS

Shiraz Yousef Badaa* and Adnan Dayoub

ABSTRACT

Background: Neonatal thrombocytopenia is common in both preterm and term neonates admitted to the neonatal intensive care unit (NICU), and is associated with significant morbidity and mortality. Objective: The aim of this study was to investigate the predictive value of an early decline in platelet count in relation to final outcomes, as well as the subsequent development of major comorbidities. Patients and Methods: A prospective analytic cohort study was conducted over one year (2023–2024) at Lattakia University Hospital, Syria. The study included four groups of premature neonates admitted to the NICU. Platelet counts were assessed on admission and on the seventh day of life. Group I consisted of 22 neonates (no thrombocytopenia, no decrease in platelet count), group II included 78 neonates (no thrombocytopenia, but a reduction in platelet count), group III had thrombocytopenia without a reduction in platelet count, and group IV had both thrombocytopenia and a reduction in platelet count. The final outcomes were compared among the four groups. Results: A total of 140 premature neonates were included (57 males [40.7%] and 83 females [59.3%]), with a mean gestational age of 29.5 ± 1.8 weeks. Gestational age and birth weight were significantly lower in group IV, which also had a higher frequency of cesarean deliveries (p < 0.05). Intraventricular hemorrhage (IVH) and necrotizing enterocolitis (NEC) were observed only in groups II and IV, with significantly higher rates in group IV (p < 0.05). Hospitalization was significantly longer in groups II (54.4 ± 8.2 days) and IV (49.9 ± 8.7 days) compared to group III (25.5 ± 3.2 days) and group I (18.1 ± 2.9 days) (p = 0.0001). A reduction in platelet count before the 7th day of life was associated with an increased risk of mortality (RR: 5.3, p = 0.0001). Conclusion: The current study demonstrates that a reduction in platelet count during the first week of life may be an independent predictor of mortality and morbidity in premature neonates.

Keywords: Decline, early, neonates, mortality, platelet, Premature.