Contributions
Abstract: EP1138
Type: E-Poster Presentation
Session title: Platelet disorders
Background
Neonatal anemia, neutropenia, and thrombocytopenia are common hematological problems in neonatal intensive care units. In the literature, there are studies evaluating neonatal anemia, thrombocytopenia, and neutropenia; but to date, no study has investigated the prevalance, risk factors, and outcome of neonatal bicytopenia and pancytopenia.
Aims
In our study, we aimed to evaluate the prevalence, risk factors, and outcome of bicytopenia and pancytopenia in neonates.
Methods
A retrospective analysis was conducted on the medical records of 2672 neonates hospitalized at neonatal intensive care unit between January 1, 2015 and January 1, 2019 and those with bicytopenia or pancytopenia were enrolled. Hemoglobin, neutrophil, and platelet counts were obtained from a whole blood EDTA sample taken from newborns for routine medical treatment. A hemoglobin concentration <7 gr/dL was accepted as severe anemia. Platelet count <50,000/mm3 was accepted as severe thrombocytopenia. An absolute neutrophil count of <500/μL was accepted as severe neutropenia. The study was approved by the local ethics committee.
Results
Bicytopenia or pancytopenia was detected in 103 (3.8%) of 2672 newborns. The prevalence of bicytopenia and pancytopenia was 3.4% and 0.4%, respectively. The most common clinical findings in both pancytopenic and bicytopenic patients were pallor (63.6% and 53%, respectively) and bleeding (45.4% and 35%, respectively). Anemia and thrombocytopenia were found in 69.6% of bicytopenic patients, neutropenia and thrombocytopenia in 25%, and anemia and neutropenia in 5.4%. When prenatal risk factors were investigated, it was observed that bicytopenia and pancytopenia were more common in preterm babies compared to term babies (p<0.0001, p=0.02, respectively) and preterm infants with very low birth weight had increased risk for development of bicytopenia and pancytopenia (p=0.008, p=0.046, respectively). Asphytic delivery and gestational hypertension were found to be significant risk factors for development of bicytopenia (p<0.0001, p<0.0001). Sepsis (42.2%) and congenital heart anomaly (21.5%) were the two most common underlying diseases in neonates with bicytopenia; sepsis was also found to be the most common underlying disease in neonates with pancytopenia. Mean postnatal age of detection of bicytopenia was 8±7.3 days, nadir was 9±7.6 days, and resolving day was 5±4.6 days. Mean postnatal age of detection of pancytopenia was 7±6.4 days, nadir was 9±7.2 days, and resolving day was 7±6.4 days. Blood product transfusion was given to 76% of bicytopenic patients and 100% of pancytopenic patients. Bicytopenia or pancytopenia recurred in 4.9% of the patients within the first month. Among newborns with bicytopenia or pancytopenia, 4.8% had severe anemia and 32% had severe thrombocytopenia. The presence of severe anemia, severe thrombocytopenia, and the need for mechanical ventilation were found to be poor prognostic factors leading to a prolonged recovery period. Death occurred in 15.2% of bicytopenic patients and 27.3% of pancytopenic patients. Sepsis was the most common cause of death in these patients.
Conclusion
This study showed that prematurity, asphytic delivery, and gestational hypertension are important prenatal risk factors for development of neonatal bicytopenia and pancytopenia. Sepsis was the most common underlying disease and cause of death in these newborns. Poor outcome due to neonatal bicytopenia and pancytopenia may be improved by eliminating preventable risk factors.
Keyword(s): Neonate, Pancytopenia, Thrombocytopenia
Abstract: EP1138
Type: E-Poster Presentation
Session title: Platelet disorders
Background
Neonatal anemia, neutropenia, and thrombocytopenia are common hematological problems in neonatal intensive care units. In the literature, there are studies evaluating neonatal anemia, thrombocytopenia, and neutropenia; but to date, no study has investigated the prevalance, risk factors, and outcome of neonatal bicytopenia and pancytopenia.
Aims
In our study, we aimed to evaluate the prevalence, risk factors, and outcome of bicytopenia and pancytopenia in neonates.
Methods
A retrospective analysis was conducted on the medical records of 2672 neonates hospitalized at neonatal intensive care unit between January 1, 2015 and January 1, 2019 and those with bicytopenia or pancytopenia were enrolled. Hemoglobin, neutrophil, and platelet counts were obtained from a whole blood EDTA sample taken from newborns for routine medical treatment. A hemoglobin concentration <7 gr/dL was accepted as severe anemia. Platelet count <50,000/mm3 was accepted as severe thrombocytopenia. An absolute neutrophil count of <500/μL was accepted as severe neutropenia. The study was approved by the local ethics committee.
Results
Bicytopenia or pancytopenia was detected in 103 (3.8%) of 2672 newborns. The prevalence of bicytopenia and pancytopenia was 3.4% and 0.4%, respectively. The most common clinical findings in both pancytopenic and bicytopenic patients were pallor (63.6% and 53%, respectively) and bleeding (45.4% and 35%, respectively). Anemia and thrombocytopenia were found in 69.6% of bicytopenic patients, neutropenia and thrombocytopenia in 25%, and anemia and neutropenia in 5.4%. When prenatal risk factors were investigated, it was observed that bicytopenia and pancytopenia were more common in preterm babies compared to term babies (p<0.0001, p=0.02, respectively) and preterm infants with very low birth weight had increased risk for development of bicytopenia and pancytopenia (p=0.008, p=0.046, respectively). Asphytic delivery and gestational hypertension were found to be significant risk factors for development of bicytopenia (p<0.0001, p<0.0001). Sepsis (42.2%) and congenital heart anomaly (21.5%) were the two most common underlying diseases in neonates with bicytopenia; sepsis was also found to be the most common underlying disease in neonates with pancytopenia. Mean postnatal age of detection of bicytopenia was 8±7.3 days, nadir was 9±7.6 days, and resolving day was 5±4.6 days. Mean postnatal age of detection of pancytopenia was 7±6.4 days, nadir was 9±7.2 days, and resolving day was 7±6.4 days. Blood product transfusion was given to 76% of bicytopenic patients and 100% of pancytopenic patients. Bicytopenia or pancytopenia recurred in 4.9% of the patients within the first month. Among newborns with bicytopenia or pancytopenia, 4.8% had severe anemia and 32% had severe thrombocytopenia. The presence of severe anemia, severe thrombocytopenia, and the need for mechanical ventilation were found to be poor prognostic factors leading to a prolonged recovery period. Death occurred in 15.2% of bicytopenic patients and 27.3% of pancytopenic patients. Sepsis was the most common cause of death in these patients.
Conclusion
This study showed that prematurity, asphytic delivery, and gestational hypertension are important prenatal risk factors for development of neonatal bicytopenia and pancytopenia. Sepsis was the most common underlying disease and cause of death in these newborns. Poor outcome due to neonatal bicytopenia and pancytopenia may be improved by eliminating preventable risk factors.
Keyword(s): Neonate, Pancytopenia, Thrombocytopenia