Normative Data on Platelet Count, Mean Platelet Volume, Platelet Distribution Width, Platelet-Large Cell Ratio, and Plateletcrit in Neonates

Introduction Platelet indices, encompassing mean platelet volume (MPV), platelet distribution width (PDW), platelet-large cell ratio (P-LCR), and plateletcrit (PCT), along with platelet count, are fundamental for assessing the hematological health of neonates. In neonatal populations, especially within the first 28 days of life, establishing normative data on these indices is essential, as neonatal platelet physiology differs markedly from that of older children and adults. Elevated MPV can reflect an active bone marrow response to platelet consumption, while increased PDW may signify platelet anisocytosis and variation due to bone marrow stress. P-LCR provides insight into the proportion of large, young platelets, which may indicate hematological stress or recovery. PCT, representing total platelet volume, offers a comprehensive measure of overall platelet mass. Methodology This cross-sectional observational study was conducted at a tertiary care hospital to establish normative reference values for platelet counts and indices in neonates from 0 to 28 days. The study cohort included neonates admitted to the Neonatal Intensive Care Unit (NICU), Special Newborn Care Unit (SNCU), and postnatal wards. Platelet count and platelet indices, specifically MPV, PDW, P-LCR, and PCT, were measured using a standardized automated hematology analyzer (Yumizen H2500, Horiba, Montpellier, France) to ensure consistency and accuracy. Blood samples were collected following neonatal venipuncture protocols to minimize any pre-analytical variations that might affect platelet measurements. Stratified analysis was conducted by gestational age, birth weight, and postnatal age to provide age and condition-specific reference ranges. Descriptive statistics and percentile-based reference intervals were employed to define normative data for each parameter. Results The study analyzed a total of 999 neonatal samples, with 435 female samples and 564 male samples. The mean total platelet count (TPC) was found to be 243,059.3 ± 90,741.3 per mm³, with a reference range (5th to 95th percentile) of 135,000-430,000 per mm³. The mean MPV was 9.5 ± 1.4 fL, with a range of 7.2-12.1 fL. PDW showed a mean of 14.3 ± 4.5 fL and ranged from 8.0 to 21.9 fL. The P-LCR had a mean of 26.6 ± 8.7% with a reference range of 14.6-42.2%, and PCT averaged at 0.23 ± 0.09% within a 0.12-0.39% range. Gestational age and postnatal age had no significant correlation with TPC or platelet indices. There were no significant differences in these platelet parameters based on gender except for P-LCR. TPC negatively correlated with PDW (r = -0.132, p = 0.001) and P-LCR (r = -0.092, p = 0.01) while showing a strong positive correlation with PCT (r = 0.879, p < .001). MPV positively correlated with P-LCR (r = 0.715, p < .001) and PCT (r = 0.295, p < .001), underscoring interdependencies among platelet indices in neonatal blood profiles. Conclusion This study provides comprehensive normative data on platelet count and indices (MPV, PDW, P-LCR, and PCT) in neonates within the first 28 days of life. The reference ranges established here can serve as critical benchmarks for neonatal hematological assessment, offering clinicians reliable parameters for interpreting platelet profiles in neonates.