ThrombocytopeniaThrombocytopenia A platelet count that is lower than normal. affects 45.9% of neonates admitted to the neonatal intensive care unitNeonatal intensive care unit A specialized hospital unit for newborns who need close monitoring and treatments such as platelet transfusions. (NICUNeonatal intensive care unit A specialized hospital unit for newborns who need close monitoring and treatments such as platelet transfusions.) in Mongolia and is significantly associated with mortality, according to an abstract presented at the 2026 International Society on Thrombosis and Haemostasis Congress in Paris, France.
What is thrombocytopenia?
Thrombocytopenia in fetal and neonatal alloimmune thrombocytopeniaFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth. (FNAITFetal and neonatal alloimmune thrombocytopenia A rare condition in which a mother’s immune system attacks fetal platelets, leading to dangerously low platelet levels before and/or after birth.) refers to an abnormally low number of platelets in the fetus or newborn as a result of an immune reaction. This occurs when the mother’s immune system produces antibodies that target the fetal platelets, typically due to a mismatch in human platelet antigens (HPAs) between the mother and fetus. The maternal antibodies cross the placenta and attack the fetal platelets, leading to their destruction.
Thrombocytopenia affects 1% to 5% of healthy neonates. “However, its incidence is notably higher (22%-35%) among sick neonates admitted to [the NICU], with severe thrombocytopeniaSevere thrombocytopenia A dangerously low platelet count, typically below 50,000 platelets per microliter and sometimes far lower in FNAIT. being implicated in increased neonatal mortality according to multiple studies,” the authors wrote.
Numerous conditions can contribute to thrombocytopenia in babies. When other standard risk factors are absent, doctors may investigate rarer conditions, including fetal and neonatal alloimmune thrombocytopenia (FNAIT).
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The researchers evaluated medical records from 1,164 infants admitted to the NICU of Mongolia’s National Center for Maternal and Child Health between 2017 and 2019. Using this data, they determined the incidence of thrombocytopenia, notable risk factors and the associated mortality risk.
Read more about FNAIT prognosis
Babies whose mothers had TORCH infections, a group of infections that can pass to the baby during pregnancy or delivery, had 40% higher odds of thrombocytopenia. These infections include toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus and other viruses.
Several neonatal conditions were also associated with the onset of thrombocytopenia. Of these, sepsis showed the strongest association: infants with sepsis had 5.4 times the odds of thrombocytopenia than those without.
Respiratory distress syndrome and low oxygen or blood flow during birth were also linked with thrombocytopenia, as were gastrointestinal conditions such as congenital malformations and necrotizing enterocolitis. Other influencing factors included low birth weight and intrauterine growth restriction.
Of the 239 neonates who died during the study period, 182 (76.1%) had thrombocytopenia. Overall, infants with thrombocytopenia had 2.62 times the odds of mortality than those without.
Together, these findings underscore the elevated prevalence of thrombocytopenia in NICU-admitted newborns and its strong association with mortality. Improved monitoring of high-risk individuals may help to improve patient outcomes.
