The Analysis Of Neonatal Thrombocytopenia In356Infants

Neonatal thrombocytopenia（NTP） is a common and serious disease ofPediatrics with high incidence of20%~40%in critical neonates。In recentyears, domestic and foreign experts think, platelet count level in peripheralblood can be used as NTP critical score index, and the prognosis of NTPneonates is closely related to the platelet count level and the causes of NTP.The cases of different gestational period respectively has its pathogenesis andclinical features According to various causes,the clinical features of NTP isdifferent. This paper aims to compare the diffence of the pathogenesis,treatment manifestation and prognosis, in order to provide some reference forbetter diagnosis, prevention and treatment. There were3108cases, who bornin The First Hospital of Jilin University between Jan2011and Dec2011,356cases were admitted NTP (PLT count less than100×10~9/L)，whose age wasless than28d，data was intact. According to the gestational age，Total of356infants were assigned into three groups:123were in early-preterm-group，80in late-preterm-group，153in term-baby-group. Data of the three groups wereanalysed depending on the difference of incidence, clinical features andprognosis, including: l.the causes of NTP:①maternal:the abnormalities ofamniotic fluid or placenta;②neonatal:asphyxia; syphilis;pneumonia;sepsis;neonatal respiratory distress syndrome;2.Clinical features:platelet count;occurrence time of NTP.Results: The incidence of neonatal thrombocytopenia was11.5%(356/3108) among the cases, which accounted for57%preterm infants,43%terminfants. The mortality of NTP was17.1%.In the research the platelet count≤50×10~9/L was38.7%. NTP duration≤7days was58.1%. In the research thrombocytopenia in pregnancy was2.5%(9/356), placental abnormalitieswas10.7%(38/356), abnormal amniotic fluid was25.5%(91/356). Thecommon causes of neonatal thrombocytopenia were: sepsis36%(128/356),neonatal respiratory distress syndrome34.8%(124/356), asphyxia21.9%(78/356), congenital cytomegalovirus infection18.3%(65/356), fungalinfection10.4%(37/356), arteriovenous blood transfusion5%(18/356syphilis), syphilis2.8%(10/356).Compared the three groups, NTP duration≤7days, abnormal amniotic fluid, blood transfusion, sepsis, fungal infectionsand CMV infection had statistical significance.Conclusions:1.The neonatal thrombocytopenia incidence was11.5%in the research.The premature infants were more than the term infants. There were morepremature infants than term infants of thrombocytopenia induced by sepsis.2.The common causes of the neonatal thrombocytopenia were: Sepsis,neonatal respiratory distress syndrome, asphyxia, congenital cytomegalovirusinfection, fungal infection, arteriovenous exchange transfusion, syphilis.3. Compared the early-preterm-infants group and the term-infants group,fungal infection was the risk factor in the early-preterm-infants group, andabnormal amniotic fluid, blood transfusion were the risk factors in theterm-infant group.4. The onset times in the early preterm infants of NTP was more than1weeks after birth, while the onset time was less than1weeks after birth in theterminal preterm and term infants of NTP.