title: Early-onset thrombocytopenia in near-term and term infants with perinatal asphyxia.
abstract: BACKGROUND
  Neonates after perinatal asphyxia are at increased risk of thrombocytopenia. The correlation between perinatal asphyxia and the risk and severity of early-onset thrombocytopenia is not well known.
  
  
  OBJECTIVE
  To estimate the incidence, severity and risk factors for early-onset thrombocytopenia in neonates after perinatal asphyxia.
  
  
  METHODS
  We included all newborns (gestational age ≥ 36 weeks) admitted to our neonatal nursery due to perinatal asphyxia in this retrospective study. We collected platelet counts that were obtained within the first 48 h of life to estimate the incidence and severity of early-onset thrombocytopenia.
  
  
  RESULTS
  A total number of 171 neonates with perinatal asphyxia were included in the study. The incidence of early-onset thrombocytopenia (platelet count < 150 × 109/l) was 51% (87/171). Several factors were associated with increased risk of early-onset thrombocytopenia, including prolonged prothrombin time (PT) [odds ratio (OR) 1·18, 95% confidence interval (CI) 1·08–1·30, P < 0·01], prolonged activated partial thromboplastin time (APTT) (OR 1·07, 95% CI 1·03–1·11, P < 0·01), low Apgar score at 10 min (OR 1·25, 95% CI 1·08–1·45, P < 0·01) and high serum lactate (OR 1·12, 95% CI 1·06–1·19, P < 0·01). After multiple logistic regression analysis, we found an independent association between early-onset thrombocytopenia and prolonged PT (OR 1·15, 95% CI 1·00–1·33, P = 0·045) and higher lactate level (OR 1·15, 95% CI 1·03–1·28, P = 0·01).
  
  
  CONCLUSIONS
  Early-onset thrombocytopenia occurs frequently in neonates after perinatal asphyxia and is independently associated with PT and lactate level.
authors.forename: N
authors.initials: N
authors.lastname: Boutaybi
authors.forename: S J
authors.initials: SJ
authors.lastname: Steggerda
authors.forename: V E H J
authors.initials: VE
authors.lastname: Smits-Wintjens
authors.forename: E W
authors.initials: EW
authors.lastname: van Zwet
authors.forename: F J
authors.initials: FJ
authors.lastname: Walther
authors.forename: E
authors.initials: E
authors.lastname: Lopriore
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000209:etiology