Thrombocytopenia as predictor of neonatal sepsis in NICU of Erbil Pediatric hospitals

Background and objective: Neonatal thrombocytopenia is a common condition in neonatal intensive care unit newborns. The aim of this study was to explore the prognostic value of thrombocytopenia as a screening and monitoring tool in neonatal sepsis. Methods: This cross-sectional study was conducted on neonates hospitalized in neonatal intensive care unit of two centers in Erbil, Iraq, during a period of 6 months with probable or proven sepsis. Thrombocytopenia cases are divided into mild (101-149×109/L), moderate (51-100×109/L), severe (21-50×109/L), and very severe (≤20×109/L) based on platelet count. Prenatal (maternal fever and membrane rupture duration) and post-natal (clinical examination results, laboratory parameters, blood culture and mortality rate) finding were recorded. Results: In this study, a total of 82 neonates admitted with proven (63.41%) or possible (36.59%) diagnoses of sepsis with an average age of 12.31±7.87 days were investigated (63.4% male). the most common symptoms were poor feeding (75.6%), and lethargy (57.3%). Among all neonates, 14.6% died. Thrombocytopenia was reported in 90.2% of neonates. The frequency of severe thrombocytopenia in the deceased (83.3%) was significantly higher than that of the discharged (34.3%) (P<0.05). Conclusion: Thrombocytopenia has a definite association with neonatal sepsis. The presence and severity of thrombocytopenia can serve as an important indicator of prognosis of infants with sepsis admitted to the neonatal intensive care unit.