Drop in platelet counts in extremely preterm neonates and its association with clinical outcomes

Shantanu Rastogi, Inan Olmez, Alok Bhutada, Deepa Rastogi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

BACKGROUND: Thrombocytopenia is a common finding among preterm neonates and has been associated with mortality and morbidities. In recent studies in adults, the drop in platelet numbers has been shown to be a predictor of clinical outcomes. Although drop in the platelet counts with or without thrombocytopenia has also been observed in neonates, its association with mortality and morbidity has not been investigated in the preterm population. OBJECTIVE: To study the prevalence of a 30% drop in platelet counts in preterm neonates and its association with clinical outcomes. METHODS: Retrospective chart review was done on neonates born at gestational age ≤28 weeks and survived for 7 days. As with the adult studies, a 30% drop in platelet numbers were identified at 7 days and 28 days of age and their association with mortality, morbidities, and length of stay (LOS) was investigated. RESULTS: Two hundred eighty-six patients included in the study had a mean gestational age of 26.3 weeks (range, 23 to 28 wk) and birth weight of 899±215 grams. A 30% drop in platelet counts occurred in 68.1% neonates. It was significantly associated with mortality (P<0.001), morbidities at both 7 and 28 days [intraventricular bleed (P<0.01)], retinopathy of prematurity (P<0.01), necrotizing enterocolitis (P<0.05) and gram-positive infections (P<0.05), and LOS (P<0.01). Only those neonates who had a 30% drop in the platelet numbers developed gram negative and fungal infections. These associations of clinical morbidities and mortality with a 30% drop in platelet counts were independent of thrombocytopenia. CONCLUSIONS: A 30% drop in platelet counts is associated with increased mortality, morbidities, and LOS in preterm neonates, independent of thrombocytopenia. As the drop occurs before the onset of clinical morbidity, one potential application is its use to predict the onset of morbidities including necrotizing enterocolitis, intraventricular hemorrhage, and retinopathy of prematurity, and a prolonged LOS and mortality.

Original languageEnglish (US)
Pages (from-to)580-584
Number of pages5
JournalJournal of Pediatric Hematology/Oncology
Volume33
Issue number8
DOIs
StatePublished - Dec 2011

Fingerprint

Platelet Count
Newborn Infant
Morbidity
Mortality
Thrombocytopenia
Length of Stay
Retinopathy of Prematurity
Necrotizing Enterocolitis
Gestational Age
Mycoses
Birth Weight
Cross-Sectional Studies
Hemorrhage
Infection
Population

Keywords

  • clinical outcomes
  • drop in platelet counts
  • length of stay
  • morbidity
  • mortality
  • prematurity
  • thrombocytopenia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Oncology
  • Hematology

Cite this

Drop in platelet counts in extremely preterm neonates and its association with clinical outcomes. / Rastogi, Shantanu; Olmez, Inan; Bhutada, Alok; Rastogi, Deepa.

In: Journal of Pediatric Hematology/Oncology, Vol. 33, No. 8, 12.2011, p. 580-584.

Research output: Contribution to journalArticle

@article{e46600d7b8e448f2a0df68f3c27e2f65,
title = "Drop in platelet counts in extremely preterm neonates and its association with clinical outcomes",
abstract = "BACKGROUND: Thrombocytopenia is a common finding among preterm neonates and has been associated with mortality and morbidities. In recent studies in adults, the drop in platelet numbers has been shown to be a predictor of clinical outcomes. Although drop in the platelet counts with or without thrombocytopenia has also been observed in neonates, its association with mortality and morbidity has not been investigated in the preterm population. OBJECTIVE: To study the prevalence of a 30{\%} drop in platelet counts in preterm neonates and its association with clinical outcomes. METHODS: Retrospective chart review was done on neonates born at gestational age ≤28 weeks and survived for 7 days. As with the adult studies, a 30{\%} drop in platelet numbers were identified at 7 days and 28 days of age and their association with mortality, morbidities, and length of stay (LOS) was investigated. RESULTS: Two hundred eighty-six patients included in the study had a mean gestational age of 26.3 weeks (range, 23 to 28 wk) and birth weight of 899±215 grams. A 30{\%} drop in platelet counts occurred in 68.1{\%} neonates. It was significantly associated with mortality (P<0.001), morbidities at both 7 and 28 days [intraventricular bleed (P<0.01)], retinopathy of prematurity (P<0.01), necrotizing enterocolitis (P<0.05) and gram-positive infections (P<0.05), and LOS (P<0.01). Only those neonates who had a 30{\%} drop in the platelet numbers developed gram negative and fungal infections. These associations of clinical morbidities and mortality with a 30{\%} drop in platelet counts were independent of thrombocytopenia. CONCLUSIONS: A 30{\%} drop in platelet counts is associated with increased mortality, morbidities, and LOS in preterm neonates, independent of thrombocytopenia. As the drop occurs before the onset of clinical morbidity, one potential application is its use to predict the onset of morbidities including necrotizing enterocolitis, intraventricular hemorrhage, and retinopathy of prematurity, and a prolonged LOS and mortality.",
keywords = "clinical outcomes, drop in platelet counts, length of stay, morbidity, mortality, prematurity, thrombocytopenia",
author = "Shantanu Rastogi and Inan Olmez and Alok Bhutada and Deepa Rastogi",
year = "2011",
month = "12",
doi = "10.1097/MPH.0b013e31821e5f44",
language = "English (US)",
volume = "33",
pages = "580--584",
journal = "Journal of Pediatric Hematology/Oncology",
issn = "1077-4114",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

TY - JOUR

T1 - Drop in platelet counts in extremely preterm neonates and its association with clinical outcomes

AU - Rastogi, Shantanu

AU - Olmez, Inan

AU - Bhutada, Alok

AU - Rastogi, Deepa

PY - 2011/12

Y1 - 2011/12

N2 - BACKGROUND: Thrombocytopenia is a common finding among preterm neonates and has been associated with mortality and morbidities. In recent studies in adults, the drop in platelet numbers has been shown to be a predictor of clinical outcomes. Although drop in the platelet counts with or without thrombocytopenia has also been observed in neonates, its association with mortality and morbidity has not been investigated in the preterm population. OBJECTIVE: To study the prevalence of a 30% drop in platelet counts in preterm neonates and its association with clinical outcomes. METHODS: Retrospective chart review was done on neonates born at gestational age ≤28 weeks and survived for 7 days. As with the adult studies, a 30% drop in platelet numbers were identified at 7 days and 28 days of age and their association with mortality, morbidities, and length of stay (LOS) was investigated. RESULTS: Two hundred eighty-six patients included in the study had a mean gestational age of 26.3 weeks (range, 23 to 28 wk) and birth weight of 899±215 grams. A 30% drop in platelet counts occurred in 68.1% neonates. It was significantly associated with mortality (P<0.001), morbidities at both 7 and 28 days [intraventricular bleed (P<0.01)], retinopathy of prematurity (P<0.01), necrotizing enterocolitis (P<0.05) and gram-positive infections (P<0.05), and LOS (P<0.01). Only those neonates who had a 30% drop in the platelet numbers developed gram negative and fungal infections. These associations of clinical morbidities and mortality with a 30% drop in platelet counts were independent of thrombocytopenia. CONCLUSIONS: A 30% drop in platelet counts is associated with increased mortality, morbidities, and LOS in preterm neonates, independent of thrombocytopenia. As the drop occurs before the onset of clinical morbidity, one potential application is its use to predict the onset of morbidities including necrotizing enterocolitis, intraventricular hemorrhage, and retinopathy of prematurity, and a prolonged LOS and mortality.

AB - BACKGROUND: Thrombocytopenia is a common finding among preterm neonates and has been associated with mortality and morbidities. In recent studies in adults, the drop in platelet numbers has been shown to be a predictor of clinical outcomes. Although drop in the platelet counts with or without thrombocytopenia has also been observed in neonates, its association with mortality and morbidity has not been investigated in the preterm population. OBJECTIVE: To study the prevalence of a 30% drop in platelet counts in preterm neonates and its association with clinical outcomes. METHODS: Retrospective chart review was done on neonates born at gestational age ≤28 weeks and survived for 7 days. As with the adult studies, a 30% drop in platelet numbers were identified at 7 days and 28 days of age and their association with mortality, morbidities, and length of stay (LOS) was investigated. RESULTS: Two hundred eighty-six patients included in the study had a mean gestational age of 26.3 weeks (range, 23 to 28 wk) and birth weight of 899±215 grams. A 30% drop in platelet counts occurred in 68.1% neonates. It was significantly associated with mortality (P<0.001), morbidities at both 7 and 28 days [intraventricular bleed (P<0.01)], retinopathy of prematurity (P<0.01), necrotizing enterocolitis (P<0.05) and gram-positive infections (P<0.05), and LOS (P<0.01). Only those neonates who had a 30% drop in the platelet numbers developed gram negative and fungal infections. These associations of clinical morbidities and mortality with a 30% drop in platelet counts were independent of thrombocytopenia. CONCLUSIONS: A 30% drop in platelet counts is associated with increased mortality, morbidities, and LOS in preterm neonates, independent of thrombocytopenia. As the drop occurs before the onset of clinical morbidity, one potential application is its use to predict the onset of morbidities including necrotizing enterocolitis, intraventricular hemorrhage, and retinopathy of prematurity, and a prolonged LOS and mortality.

KW - clinical outcomes

KW - drop in platelet counts

KW - length of stay

KW - morbidity

KW - mortality

KW - prematurity

KW - thrombocytopenia

UR - http://www.scopus.com/inward/record.url?scp=80455130019&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80455130019&partnerID=8YFLogxK

U2 - 10.1097/MPH.0b013e31821e5f44

DO - 10.1097/MPH.0b013e31821e5f44

M3 - Article

C2 - 22031116

AN - SCOPUS:80455130019

VL - 33

SP - 580

EP - 584

JO - Journal of Pediatric Hematology/Oncology

JF - Journal of Pediatric Hematology/Oncology

SN - 1077-4114

IS - 8

ER -