Significance of Platelet Indices on Neonatal Sepsis

BACKGROUND: The neonatal sepsis (NS) is a life-threatening condition contributing significantly to neonatal morbidity and mortality worldwide. Early and accurate diagnosis remains challenging due to nonspecific clinical presentations and limitations of traditional diagnostic methods such as blood cultures. Potential biomarkers for NS have been suggested using platelet indices, which include mean platelet volume (MPV) and platelet distribution width (PDW). OBJECTIVE: The purpose of this study was to evaluate PDW, MPV, as well as the platelet count in neonates with culture-proven and probable sepsis, to compare them to healthy neonates, and to evaluate their potential role as diagnostic markers. MATERIALS AND METHODS: A cross-sectional observational study was conducted at Imamein Kadhimein Medical City over 7 months. A total of 166 neonates were categorized into three groups: culture-proven NS, probable NS (PNS), and healthy controls. Platelet indices were analyzed using an automated hematology analyzer, and blood cultures were performed to identify causative pathogens. RESULTS: Neonates with late-onset sepsis were more than those with early-onset sepsis for both NS and PNS groups. Thrombocytopenia was significantly associated with NS ( P = 0.002). The MPV was significantly much higher in NS cases in contrast to the PNS and control groups ( P = 0.036). The PDW showed a nonsignificant increase in NS cases. Gram-negative bacteria were more frequently isolated (69.8%) and were correlated with significantly higher MPV ( P = 0.029) and PDW ( P = 0.030) compared to Gram-positive infections. CONCLUSION: Platelet indices, particularly MPV and PDW, may serve as useful biomarkers for early NS diagnosis. These findings suggest their potential incorporation into routine sepsis screening protocols to improve diagnostic accuracy and timely management. Further large-scale studies are recommended to validate these results.