Association of thrombocytopenia and delivery method with intraventricular hemorrhage among very-low-birth-weight infants.
ABSTRACT To investigate the significance of neonatal thrombocytopenia and delivery method on the incidence of intraventricular hemorrhage in infants weighing <1500 g.
A total of 1283 infants weighing <1500 g who were admitted to six neonatal intensive care units over 21 months were analyzed prospectively. Illness severity was measured by the Score for Neonatal Acute Physiology (SNAP).
Of the infants analyzed, 145 (11.3%) had thrombocytopenia (platelet count <100 x 10(9)/L). The incidence of intraventricular hemorrhage was greater among infants with thrombocytopenia than among those without (44.8% vs 23.9%, P <.0001). Non-thrombocytopenic infants who were delivered vaginally had a higher incidence of intraventricular hemorrhage than those delivered via cesarean section (35.8% vs 15.9%, P <.0001). Thrombocytopenic infants who were delivered vaginally had the highest incidence of intraventricular hemorrhage (63.4% vs 37.5% for cesarean section, P =.005). Vaginal delivery and platelets < 50 x 10(9)/L on day 1 were independent risk factors for intraventricular hemorrhage (OR 2.7, 95% CI 2.0-3.8 and OR 11.2, 95% CI 3.0-42.5, respectively).
This multicenter study confirms that thrombocytopenia and intraventricular hemorrhage are not uncommon in neonates who weigh <1500 g, and that the incidence of intraventricular hemorrhage is higher in those thrombocytopenic infants delivered vaginally.
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ABSTRACT: Thrombocytopenia in pregnant women may result from a number of diverse etiologies. While some of these are not associated with adverse pregnancy outcomes, others are associated with substantial maternal and/or neonatal morbidity and mortality. However, specific therapies, if instituted promptly, may significantly improve the outcomes of affected patients and their offspring. Since the clinical features of many of these disorders often overlap, identifying a specific cause of thrombocytopenia in a pregnant patient may be difficult. However, through familiarity with the more common clinical and laboratory features of each of these disorders, accurate diagnosis may be achieved, and appropriate treatment instituted in most cases. In this review, we discuss the differential diagnosis of the more common causes of pregnancy-associated thrombocytopenia, and provide an overview of approaches to hematologic management.Blood Reviews 04/2003; 17(1):7-14. · 5.36 Impact Factor