Thrombocytopenia, a condition often associated with fetal and neonatal alloimmune thrombocytopenia (FNAIT), strongly predicted which premature infants would face serious health complications, according to a study published recently in Cureus.
This retrospective study included 443 newborns born between 22 and 32 weeks of gestation. The results suggest that early platelet problems, combined with extreme prematurity and mechanical ventilation, can help doctors and parents anticipate which babies are most likely to develop multiple illnesses such as bronchopulmonary dysplasia, intraventricular hemorrhage, and retinopathy of prematurity.
“[E]xtremely preterm gestation, mechanical ventilation and thrombocytopenia are the main predictors for the diagnosis of more than one of the studied morbidities, which is of utmost importance in understanding the health outcomes of immature infants,” explained this study’s authors.
Among the 443 surviving infants, 60.7% had no signs of bronchopulmonary dysplasia, intraventricular hemorrhage, or retinopathy of prematurity, and 39.3% developed at least one of these complications. Of those affected, 110 had one condition, and 64 had two or all three.
Read more about the prognosis of FNAIT
The risk of surviving without any of these diseases dropped significantly in infants with thrombocytopenia, as it did in those born extremely preterm, who required mechanical ventilation or who developed sepsis or necrotizing enterocolitis.
In contrast, infants whose mothers experienced preeclampsia were more likely to survive free of these conditions. Researchers noted that the connection between preeclampsia and better outcomes has not been consistently observed in previous studies, warranting further investigation into how this maternal condition might protect vulnerable infants.
Infants with platelet-related problems such as thrombocytopenia, which could be due to infection, prematurity, or immune causes such as FNAIT, were especially prone to having multiple morbidities. This study found that these infants, along with those born at 22 to 27 weeks, faced three to four times higher rates of bronchopulmonary dysplasia, intraventricular hemorrhage and retinopathy of prematurity than those born later.
For patients and families, these results underscore the importance of early identification and close monitoring for infants born very prematurely or with low platelet counts. Recognizing thrombocytopenia’s link to FNAIT and other neonatal risks could guide treatment decisions, improve survival rates without major disabilities, and help parents better understand the medical challenges their infants may face.
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