Hypoxia as a Predisposing Factor for the Development of Early Onset Neonatal Thrombocytopenia

BACKGROUND: Thrombocytopenia in hypoxic neonates admitted in NICU is a morbid condition encountered very commonly. Early-onset thrombocytopenia (<72 h) is most commonly associated with fetomaternal conditions complicated by placental insufficiency and/or fetal hypoxia. Chronic intrauterine hypoxia is the most frequent cause of early-onset thrombocytopenia in preterm neonates. AIMS: In this study incidence and clinical impact of early thrombocytopenia in hypoxic neonates was investigated. SETTING AND DESIGN: Neonatal intensive care unit of a tertiary level hospital attached to a medical college in Central India. A cross-sectional, observational hospital based study in hypoxic neonates for development of thrombocytopenia. MATERIALS AND METHODS: 603 hypoxic newborns were evaluated for development of thrombocytopenia. 155 (25.07%) developed thrombocytopenia and were the cases. Non thrombocytopenic babies 448 (74.29%) served as controls. The two groups were compared for birth weight, sex ratio, gestational age, severity of asphyxia, platelet counts and mortality rate. STATISTICAL ANALYSIS: Descriptive statistics of continuous variable were expressed in mean and SD. P value less than or equal to 0.05 were statistically significant. RESULTS AND CONCLUSIONS: We found thrombocytopenia to be associated with male gender, prematurity and low birth weight. Most babies had mild to moderate thrombocytopenia. Mortality was higher in preterm thrombocytopenic babies as compared to term. We suggest screening for thrombocytopenia in all asphyxiated newborns, as hypoxia can lead to neonatal thrombocytopenia.