IS THROMBOCYTOPENIA A RISK FACTOR FOR SEPSIS IN NEONATES? : A PROSPECTIVE STUDY

Abstract

Background:Neonatal Sepsis is a systemic inflammatory response to infection and/or
isolation of bacteria from the blood stream in the first 28 days of life.Thrombocytopenia,
defined asplatelet count below 150×109
/L, is a frequent problem in neonatal intensive care
units, confounding the clinical course in 22–35% of intensive care admissions.Sepsis is the
commonest cause of neonatal mortality; it is responsible for about 30-50% of the total
neonatal deaths in developing countries.
Objectives: The aim of this study is to analyze the possible risk factors for neonatal
thrombocytopenia, its association with neonatal sepsis and the outcome of neonatal sepsis.
Methods: This is a prospective study conducted on 68 babies in NICU of a tertiary care
centre. The babies admitted in the NICU with platelet count below 150×109
/L were taken into
consideration. The study included consent by parents/guardian, data collection by meticulous
history taking and clinical examination, appropriate laboratory investigations followed by
statistical correlations.
Results:Study was conducted with 68 neonates having platelet countbelow 150×109
/L. Risk
factors of neonatal thrombocytopenia involved maternal factors like pre-eclampsia/
pregnancy induced hypertension, premature rupture of membranes, meconium stained liquor,
multiparity as well as fetal factors like low birth weight, prematurity, birth asphyxia etc.There
was male predominance (70%) amongst study population.Most of the study population had
severe thrombocytopenia (47%) followed by moderate thrombocytopenia (42%) and mild
thrombocytopenia (11%). 82.4% of study population survived while death occurred in 17.6%.
Conclusion:The present study concludes thatthere is an association of neonatal
thrombocytopenia and sepsis. Thrombocytopenia is an earliest indicator as well as a
prognostic marker of neonatal sepsis. Most common etiological factors include PROM, low birth weight, prematurity, maternal GBS colonization, birth asphyxia, PIH, multiple
gestation, chorioamnionitis and invasive procedures. Starting of empirical antibiotics
becomes the mainstay of the treatment. If managed early and effectively, neonatal sepsis has
promising outcomes.