The relationship between thrombocytopenia and intraventricular hemorrhage in neonates with gestational age 35 weeks
Abstract: The prevalence of
thrombocytopenia in neonates ranges from 22 to 35%, and one of the most feared
complications is intraventricular hemorrhage (IVH). Previous research in Cipto
Mangunkusumo Hospital (CMH), Jakarta reported a high incidence of IVH (43.47%)
in infants with a gestational age of <35 weeks. Intraventricular hemorrhage
causes disturbances in neurological development and can be fatal. In Indonesia,
research on the relationship between thrombocytopenia and IVH has been
limited.
Objective To study the relationship between thrombocytopenia and IVH in
neonates with gestational age <35 weeks and assess for a correlation between
the severity of thrombocytopenia and the severity of IVH.
Methods This cross-sectional study was performed by reviewing medical
records in the Neonatology Division of the Child Health Department, University
of Indonesia, CMH. Subjects were neonates hospitalized from January 2012 to
December 2014 with IVH. Subjects were categorized into either mild to moderate
IVH (grade ≤2) or severe IVH (grade >2). Thrombocyte counts were recorded on
the same day as the diagnosis of IVH.
Results The risk of severe IVH was 28.2% in neonates with thrombocyte
counts <100,000/uL, and 10.4% in neonates without thrombocytopenia
(P=0.014). Multivariate analysis revealed that gestational age <32 weeks and
the use of respiratory support (ventilator and high frequency oscillatory
ventilation) had significant associations with severe IVH. However,
multivariate analysis did not show a significant relationship between
thrombocytopenia and severe IVH (correlation coefficient = 0.21).
Conclusion Thrombocytopenia is not significantly associated with the
incidence of severe IVH based on multivariate analysis. Also, the severity of
thrombocytopenia has no correlation with the severity of IVH.
Author: Idha Yulandari, Lily
Rundjan, Muzal Kadim, Pustika Amalia, Haryanti F. Wulandari, Setyo Handryastuti
Journal Code: jpkedokterangg160118
