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Research Article

JCDR. 2021; 12(5): 15-21


IS THROMBOCYTOPENIA A RISK FACTOR FOR SEPSIS IN NEONATES? : A PROSPECTIVE STUDY

Dr. Ravindra S. Sonawane, Dr. Neha R. Kulkarni,Dr. Sagar V. Sonawane,Dr. Akshay N. Patil.


Abstract

Background:Neonatal Sepsis is a systemic inflammatory response to infection and/or isolation of bacteria from the blood stream in the first 28 days of life.Thrombocytopenia, defined asplatelet count below 150×109/L, is a frequent problem in neonatal intensive care units, confounding the clinical course in 22–35% of intensive care admissions.Sepsis is the commonest cause of neonatal mortality; it is responsible for about 30-50% of the total neonatal deaths in developing countries.
Objectives: The aim of this study is to analyze the possible risk factors for neonatal thrombocytopenia, its association with neonatal sepsis and the outcome of neonatal sepsis.
Methods: This is a prospective study conducted on 68 babies in NICU of a tertiary care centre. The babies admitted in the NICU with platelet count below 150×109/L were taken into consideration. The study included consent by parents/guardian, data collection by meticulous history taking and clinical examination, appropriate laboratory investigations followed by statistical correlations.
Results:Study was conducted with 68 neonates having platelet countbelow 150×109/L. Risk factors of neonatal thrombocytopenia involved maternal factors like pre-eclampsia/ pregnancy induced hypertension, premature rupture of membranes, meconium stained liquor, multiparity as well as fetal factors like low birth weight, prematurity, birth asphyxia etc.There was male predominance (70%) amongst study population.Most of the study population had severe thrombocytopenia (47%) followed by moderate thrombocytopenia (42%) and mild thrombocytopenia (11%). 82.4% of study population survived while death occurred in 17.6%.
Conclusion:The present study concludes thatthere is an association of neonatal thrombocytopenia and sepsis. Thrombocytopenia is an earliest indicator as well as a prognostic marker of neonatal sepsis. Most common etiological factors include PROM, low birth weight, prematurity, maternal GBS colonization, birth asphyxia, PIH, multiple gestation, chorioamnionitis and invasive procedures. Starting of empirical antibiotics becomes the mainstay of the treatment. If managed early and effectively, neonatal sepsis has promising outcomes.

Key words: Early onset sepsis, Late onset sepsis, Neonatal Thrombocytopenia






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