title: Thrombocytopenia in the first 24 hours after birth and incidence of patent ductus arteriosus.
abstract: BACKGROUND
  Experimental studies suggest that platelet-triggered ductal sealing is critically involved in definite ductus arteriosus closure. Whether thrombocytopenia contributes to persistently patent ductus arteriosus (PDA) in humans is controversial. This was a retrospective study of 1350 very low birth weight (VLBW; <1500 g) infants, including 592 extremely low birth weight (ELBW; <1000 g) infants.
  
  
  METHODS
  All infants who had a platelet count in the first 24 hours after birth and an echocardiogram performed on day of life 4 to 5 were included. The incidence of thrombocytopenia was analyzed in infants with and without PDA, and in those who did or did not undergo PDA intervention. The impact of thrombocytopenia, gestational age, birth weight, gender, and sepsis on PDA was determined by receiver operating characteristic curve, odds ratio, and regression analyses.
  
  
  RESULTS
  Platelet numbers within the first 24 hours after birth did not differ between VLBW/ELBW infants with and without spontaneous ductal closure. Platelet numbers were not associated with subsequent PDA treatment. Low platelet counts were not related to failure of pharma-cologic PDA treatment and the need for subsequent surgical ligation. Lower gestational age or birth weight, male gender, and sepsis were linked to the presence of PDA in VLBW infants on day of life 4 to 5.
  
  
  CONCLUSIONS
  Thrombocytopenia in the first 24 hours after birth was not associated with PDA in this largest VLBW/ELBW infant cohort studied to date. Impaired platelet function, due to immaturity and critical illness, rather than platelet number, might play a role in ductus arteriosus patency.
authors.affiliation: Department of Neonatology, Charité University Medical Center, Berlin, Germany.
authors.forename: Hannes
authors.initials: H
authors.lastname: Sallmon
authors.forename: Sven C
authors.initials: SC
authors.lastname: Weber
authors.forename: Britta
authors.initials: B
authors.lastname: Hüning
authors.forename: Anja
authors.initials: A
authors.lastname: Stein
authors.forename: Peter A
authors.initials: PA
authors.lastname: Horn
authors.forename: Boris C
authors.initials: BC
authors.lastname: Metze
authors.forename: Christof
authors.initials: C
authors.lastname: Dame
authors.forename: Christoph
authors.initials: C
authors.lastname: Bührer
authors.forename: Ursula
authors.initials: U
authors.lastname: Felderhoff-Müser
authors.forename: Georg
authors.initials: G
authors.lastname: Hansmann
authors.forename: Petra
authors.initials: P
authors.lastname: Koehne
mesh_terms: D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use; D004374:Ductus Arteriosus, Patent / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D007052:Ibuprofen / Q000627:therapeutic use; D007213:Indomethacin / Q000627:therapeutic use; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008297:Male; D010976:Platelet Count; D018805:Sepsis / Q000150:complications; D013921:Thrombocytopenia / Q000097:blood / Q000150:complications*
chemical_list: D016861:Cyclooxygenase Inhibitors; D007052:Ibuprofen; D007213:Indomethacin