A Prospective Study on the Incidence and Outcomes of Neonatal Thrombocytopenia at a Tertiary Care Facility in Central Saudi Arabia.
Mohamed Eltawel, Talal AlHarbi, Khaled AlJamaan and 3 others
PMID 30044242WHAT IT FOUND
Neonatal thrombocytopenia was confirmed in 84 of 4379 deliveries, or 1.9%, at one Saudi tertiary centre.
Most live infants were managed with monitoring alone, but some needed platelet transfusion, IVIG, or both, and three died.
Key findings
0184 neonates with thrombocytopenia were identified among 4379 deliveries, a period incidence of 1.9%.
0252 neonates were managed with monitoring alone, 9 received platelet transfusion, 8 received IVIG, and 12 received platelet transfusion and IVIG together.
03A larger increase in platelet count from onset to recovery was associated with higher gestational age, treatment, and late-onset disease.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at one tertiary centre in Saudi Arabia, so the 1.9% incidence may not apply to other nurseries. Only 84 neonates were identified, and 81 live neonates were analysed for outcomes, so the study had limited statistical power. Complete blood counts were not obtained for all newborns before discharge, so reported onset may have been later than true onset. Neonates who died were excluded from outcome analyses, so recovery and platelet change results apply only to survivors. Treatment was not randomised, and infants received monitoring, platelet transfusion, IVIG, or both, so the effect of any single treatment cannot be separated. The study reports associations, not cause and effect, and consanguinity was not initially recognised as a measured contributor.
The easy way to misread this
Do not conclude that platelet transfusion or IVIG improves recovery. Infants also received monitoring alone or both treatments together, and the study did not randomise treatment, so the contribution of any single treatment cannot be separated.