Incidence and Clinical Outcome of Neonatal Thrombocytopenia at a Tertiary Care Hospital - A Prospective Observational Study

Background: Neonatal thrombocytopenia (NT) is one amongst the most common hematological abnormality encountered in NICU. Aim of the present study was to find out the incidence and clinical outcome of NT and also studied the maternal and fetal risk factors, clinical course of NT during hospital stay. Method: A total of 100 neonates admitted to NICU were enrolled and studied in the Department of Pediatrics at Tertiary Care Centre in India during a period from 1st January 2020 to 31st December 2020. Results: The incidence of thrombocytopenia was 64%, of which severe thrombocytopenia was 32.81% in our NICU. Commonest etiologic factor associated with thrombocytopenia was septicaemia (48.43%). Neonatal factors associated with thrombocytopenia, especially severe thrombocytopenia was age at presentation, septicaemia, NEC and assisted ventilation. Maternal PIH was significantly associated with NT (p<0.001). Clinical signs and symptoms associated with severe thrombocytopenia were bleeding, purpura and delayed capillary refill. The course in the hospital for severe thrombocytopenia was relatively longer (17 days), involving longer period on supplemental oxygen (7 days) and IV fluids (12 days). Mortality (38.09%) and morbidity (4.76%) was significantly higher while discharged rate was less (61.90%) in babies with severe thrombocytopenia. Septicaemia was the commonest cause of death on whole (36.36%) followed by prematurity (27.27%), also in severely thrombocytopenic group. Conclusion: Thus, severe thrombocytopenia was found to be predictor of poor outcome in sick neonates of NICU. Also, low platelet count was an independent risk factor for poor outcome in current study. Hence it could be used as a prognostic indicator in NICU graduates.