Premature infants facing neonatal respiratory distress syndrome (NRDS) complicated by low platelet counts, which can be linked to fetal and neonatal alloimmune thrombocytopenia (FNAIT), endured more severe illness and longer hospitalizations, according to research published recently in the British Journal of Hospital Medicine.
This study found that gestational age serves as an important protective factor against this complication, with lower platelet levels closely tied to worse clinical outcomes.
The retrospective analysis included 234 premature babies treated for NRDS at the Affiliated Yangming Hospital of Ningbo University in 2024. Of those, 131 developed thrombocytopenia, or abnormally low platelet counts, while 103 did not. Platelets, which are crucial not only for blood clotting but also for lung repair and function, were shown to influence the severity of breathing problems in these vulnerable infants.
“[I]n clinical practice, clinicians should remain vigilant for various risk factors that may contribute to the development of thrombocytopenia,” explained this study’s authors. They continued, “Dynamic monitoring of platelet numbers in children with thrombocytopenia can be used to evaluate their condition and prognosis.”
Read more about the prognosis of FNAIT
Infants with platelet loss weighed less at birth, were born earlier, and scored lower on both 1-minute and 5-minute Apgar assessments compared with those without platelet complications. They also required more intensive interventions, such as blood transfusions, immune-based therapies, mechanical ventilation, and surfactant replacement. The average hospital stay in this group stretched to 21 days, compared with 12 days for those without platelet loss.
The research team used statistical modeling to determine which factors influenced outcomes. Gestational age emerged as a key protective factor, meaning that babies born later within the preterm window were less likely to experience platelet-related complications. Correlation analysis further demonstrated that lower platelet counts were strongly associated with worse disease severity, longer need for respiratory support, and higher bleeding risk.
Mothers of affected infants were more likely to have had pregnancy hypertension, prenatal infections, or received hormone treatments during pregnancy. These results highlight the maternal factors that can increase the likelihood of thrombocytopenia in premature infants and suggest opportunities for earlier monitoring and intervention.
For patients and families, this research emphasizes that platelet count can serve as a warning sign of how serious a newborn’s breathing problems may become. Recognizing the role of FNAIT and other causes of platelet loss may help doctors intervene sooner and tailor treatments more precisely. Ultimately, babies born later in pregnancy face fewer platelet complications, underscoring the importance of gestational age in protecting against both FNAIT-related and broader platelet-associated risks in NRDS.
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