Relationship Between The Platelet Counts And Prognosis In Neonatal Septicemia

Objective: To investigate the relationship between platelet counts and prognosis in newborns with septicemia.Methods: Parameters in 243 newborns with septicemia were analyzed retrospectively,to show the bacterial kinds.The difference between Gram- positive cocci and Gram -negative bacillus in neonatal septicemia were observed in terms of platelet counts and prognosis. platelet counts,the degree of critical illness (neonatal critical illness scoring, NCIS),and the incidence rate of NEC were also observed the relationship with prognosis.The relationship between different stage of NEC with platelet counts ,The effects of plate-reduction level to prognosis.Results:(1) The mortality was 11.52% (28/243), the incidence rate of thrombocytopenia was 36.63%(89/243), the mortality of thrombocytopenia was 22.47%(20/89), the incidence rate of NEC was 5.35% (13/243), Gram-positive cocci and Gram-negative bacillus [74.64%(103/138) vs 25.36%(35/138) respectively]. (2) There was no difference in sex, gestation age(weeks)(36.15+3.48 vs 37.36+3.94),birth weight(g()2603.75+882.66 vs 2833.24+941.22), and invasion age(days)( 7.72+4.92 vs 9.06+5.45) between the death group and survival group,also including pneumonia and jaundice (P>0.05).However, comparing the death group and survival group ,platelet counts(×109/L)(80.36+34.48 vs 184.73+62.70),NCIS(84.27+23.37 vs 93.45+15.63)and the incidence rate of NEC[28.57%(8/28) vs 2.73%(5/153)] were closely correlated with prognosis(P<0.05).(3) There was no difference in platelet counts (t=0.85 ,P>0.05) and the mortality of septicemia (χ2=0.037,P>0.05) between Gram-positive cocci and Gram-negative bacillus in newborns with septicemia.(4) Plate-reduction were correlated with NCIS(t=4.84, P<0.05) ,NEC(χ2=6.29,P<0.05 ) and the mortality of neonatal septicemia (χ2=16.51,P<0.05).(5) NEC stage II or higher has more level plate count than NEC stage I(t=5.60,P<0.05).(6) There was an inverse association between the mortality of neonatal septicemia and platelet count (r = -0.535; P <0.05)Conclusions:(1) Neonatal septicemia is the definite risk factor for plate-reduction.(2) There was no difference in platelet counts between Gram-positive cocci and Gram-negative bacillus in newborns with septicemia. (3) The level of plate-reduction show the severity to sepsis and is the risk factor for unfavourable prognosis. Therefor, platelet counts are good indicators of prognosis and severity in neonatal septicemia.