CAUSES AND FREQUENCY OF EARLY AND LATE ONSET NEONATAL THROMBOCYTOPENIA IN A TERTIARY CARE HOSPITAL, KARACHI

Abstract

Background: The neonatal thrombocytopenia is a common hematological disorder in neonatal intensive care units and is associated with increased risk of bleeding and adverse neonatal outcomes. The etiology differs according to the timing of onset, with early-onset thrombocytopenia commonly related to maternal and placental conditions and late-onset thrombocytopenia more often associated with neonatal illnesses.

Objectives: To determine the frequency and causes of early- and late-onset neonatal thrombocytopenia among term and preterm babies in a tertiary care hospital, Karachi.

Study Design & Setting: Analytical cross-sectional study conducted at the Neonatal Intensive Care Unit (NICU), Abbasi Shaheed Hospital, Karachi, Pakistan from 20 September 2023 to 20 September 2024.

Methodology: A total of 115 neonates with thrombocytopenia were enrolled using non-probability consecutive sampling over six months after CPSP approval. Neonates aged 28–40 weeks gestation fulfilling eligibility criteria were included. Demographic details, maternal history, perinatal factors, clinical findings, laboratory investigations, and associated neonatal morbidities were recorded using a structured proforma. Data were analyzed using IBM SPSS version 26.0. Appropriate statistical tests were applied and p<0.05 was considered statistically significant.

Results: The mean gestational age was 34.9 ± 2.8 weeks and mean birth weight was 2218 ± 614 g. Preterm neonates constituted 66.1%, while males accounted for 59.1%. Early-onset thrombocytopenia was observed in 63.5% of neonates and late-onset thrombocytopenia in 36.5%. Sepsis was the most frequent associated cause (53.0%), followed by maternal hypertensive disorder (19.1%) and necrotizing enterocolitis (13.0%). Preterm neonates had significantly lower platelet counts and higher frequency of sepsis (p<0.05).

Conclusion: Early-onset neonatal thrombocytopenia was more common than late-onset disease. Sepsis was the predominant associated cause, especially among preterm neonates, while maternal hypertensive disorders were more frequently associated with early-onset thrombocytopenia.