Thrombocytopenia as predictor of neonatal sepsis in NICU of Erbil Pediatric hospitals

Khalil Mohamad  Abdulrahman; Zaher Taher Mosheer  Gardi

doi:10.56056/amj.2025.380

Authors

Khalil Mohamad Abdulrahman M.B.Ch.B., SHO of Pediatrics in Rapareen Pediatric Teaching Hospital, Trainee of pediatrics at the Kurdistan Higher Council of Medical Specialties (KHCMS).
Zaher Taher Mosheer Gardi M.B.Ch.B., C.A.B.P (Pediatrics), Director of pediatric Program at Kurdistan Higher Council, Erbil, Supervisor at Arab board for Medical specialization/Erbil Center

DOI:

https://doi.org/10.56056/amj.2025.380

Keywords:

Neonatal intensive care unit, Neonatal sepsis, Prognosis, Thrombocytopenia

Abstract

Background and objective: Neonatal thrombocytopenia is a common condition in neonatal intensive care unit newborns. The aim of this study was to explore the prognostic value of thrombocytopenia as a screening and monitoring tool in neonatal sepsis.

Methods: This cross-sectional study was conducted on neonates hospitalized in neonatal intensive care unit of two centers in Erbil, Iraq, during a period of 6 months with probable or proven sepsis. Thrombocytopenia cases are divided into mild (101-149×109/L), moderate (51-100×109/L), severe (21-50×109/L), and very severe (?20×109/L) based on platelet count. Prenatal (maternal fever and membrane rupture duration) and post-natal (clinical examination results, laboratory parameters, blood culture and mortality rate) finding were recorded.

Results: In this study, a total of 82 neonates admitted with proven (63.41%) or possible (36.59%) diagnoses of sepsis with an average age of 12.31±7.87 days were investigated (63.4% male). the most common symptoms were poor feeding (75.6%), and lethargy (57.3%). Among all neonates, 14.6% died. Thrombocytopenia was reported in 90.2% of neonates. The frequency of severe thrombocytopenia in the deceased (83.3%) was significantly higher than that of the discharged (34.3%) (P<0.05).

Conclusion: Thrombocytopenia has a definite association with neonatal sepsis. The presence and severity of thrombocytopenia can serve as an important indicator of prognosis of infants with sepsis admitted to the neonatal intensive care unit.

Downloads

Download data is not yet available.

References

1.Talat F, Alam K, Akhtar K, Ali SM. A Clinicopathological Study of Thrombocytopenia and Platelet Indices in Neonatal Sepsis. Trends Med. Res. 2023;18 (1): 69-74, 2023.

2.Rehman A, Ali Z, Fatima N, Nadeem A. Prevalence, risk factors, severity and outcome of neonatal thrombocytopenia. TPMJ. 2022;29(10):1558-62.

3.Tirupathi K, Swarnkar K, Vagha J. Study of risk factors of neonatal thrombocytopenia. Int J Contemp Pediatr. 2017;4(1):191-6.

4.Arabdin M, Khan A, Zia S, Khan S, Khan GS, Shahid M, et al. Frequency and severity of thrombocytopenia in neonatal sepsis. Cureus. 2022;14(2).

5.Eissa DS, El-Farrash RA. New insights into thrombopoiesis in neonatal sepsis. Platelets. 2013;24(2):122-8.

6.Manzoni P. Hematologic aspects of early and late-onset sepsis in preterm infants. Clin Perinatol. 2015;42(3):587-95.

7.Mitul AR. Surgical neonatal sepsis in developing countries. J Neonatal Surg. 2015 Oct-Dec; 4(4): 41.

8.Bekele K, Bekele F, Edosa D, Mekonnen M, Benayew M. Magnitude and associated factors of neonatal sepsis among neonates admitted to neonatal intensive care unit of Northern oromia hospitals, Ethiopia: A multicenter cross-sectional study. Ann Med Surg. 2022; 78:103782.

9.Gupta B, Gupta B, Shrivastava A, Chetri P. A study of neonatal sepsis and its relation to thrombocytopenia in Neonates of Tertiary Care Hospital of Western Nepal. J Preg Child Health. 2019;6(421):2.

10.Addil F, Rehman A, Najeeb S, Imtiaz H, Khan S. Neonatal sepsis: the frequency of thrombocytopenia. Sys Rev Pharm. 2021;12(11):3460-2.

11.Ree IM, Fustolo-Gunnink SF, Bekker V, Fijnvandraat KJ, Steggerda SJ, Lopriore E. Thrombocytopenia in neonatal sepsis: Incidence, severity and risk factors. PloS one. 2017;12(10): e0185581.

12.Manzoni P, Mostert M, Galletto P, Gastaldo L, Gallo E, Agriesti G, et al. Is thrombocytopenia suggestive of organism?specific response in neonatal sepsis? Pediatr Int. 2009;51(2):206-10.

13.Ahmad I, Laghari GS, Amir M, Quddus HA, Sabir MS, Khan MM. Frequency of Thrombocytopenia and Associated Mortality in Neonates with Neonatal Sepsis. PJMHS. 2023;17(06):106-108.

14.Arif S, Ahmad I, Ali S, Khan H. Thrombocytopenia and bacterial sepsis in neonates. Indian J Hematol Blood Transfus. 2012; 28:147-51.

15.Samreen S, Manazir Ali S, Firdaus U, SH A. Early diagnosis of neonatal septicemia by using platelet indices, CRP and serum uric acid as markers. Enliven: Pediatr Neonatal Biol. 2019;6(4):001-6.

16.Kausar M, Salahuddin I, Naveed A. Examine the frequency of thrombocytopenia in newborns with neonatal sepsis. PJMHS. 2020; 12:4-68.

17.Fanaroff AA, Korones SB, Wright LL, Verter J, Poland RL, Bauer CR, et al. Incidence, presenting features, risk factors and significance of late onset septicemia in very low birth weight infants. Pediatr Infect Dis J. 1998;17(7):593-8.

18.Lim WH, Lien R, Huang YC, Chiang MC, Fu RH, Chu SM, et al. Prevalence and pathogen distribution of neonatal sepsis among very-low-birth-weight infants. Pediatr Neonatol. 2012;53(4):228-34.