Clinical Analysis of Risk Factors of Premature Infants With Respiratory Distress Syndrome Complicated With Thrombocytopenia

<b>Aims/Background</b> Neonatal respiratory distress syndrome (NRDS) is a leading cause of mortality in premature infants. Platelets play an important role in lung remodeling. The purpose of this study was to elucidate the clinical characteristics of NRDS complicated with thrombocytopenia to better guide treatment clinically. <b>Methods</b> A total of 234 premature infants diagnosed with NRDS and admitted to the Affiliated Yangming Hospital of Ningbo University between January 2024 and December 2024 were retrospectively analyzed. Three classification methods were used: the first based on platelet count, the second on gestational age, and the third on severity of NRDS. Clinical data of children and their mothers were collected. The clinical characteristics of children across different groups were analyzed, and independent risk factors for NRDS complicated by thrombocytopenia were determined using binary logistic regression analysis. <b>Results</b> The thrombocytopenia group had significantly lower birth weight, gestational age, as well as 1- and 5-minute Apgar scores compared to the non-thrombocytopenia group (<i>p</i> < 0.05). Moreover, the incidence of low Apgar scores and length of hospital stay were significantly higher in the thrombocytopenia group than in the non-thrombocytopenia group (<i>p</i> < 0.05). Binary logistic regression analysis showed that gestational age was a significant protective factor for thrombocytopenia in premature infants with NRDS. When infants were divided into extremely preterm infant (EPI), early preterm birth (EPB), and moderate-late preterm birth (MLPB) according to gestational age, significant differences were found in birth weight, 1-minute Apgar, 5-minute Apgar, minimum platelet value, use of invasive ventilation, pulmonary surfactant administration, and length of hospital stay (<i>p</i> < 0.05). Point-biserial correlation analysis showed that lower platelet counts were associated with increased NRDS severity (correlation coefficient = -0.363, <i>p</i> < 0.05). <b>Conclusion</b> NRDS accompanied by thrombocytopenia indicates a more severe condition and is associated with poorer clinical outcomes. Gestational age is an important protective factor for thrombocytopenia in premature infants with NRDS.