Lee Ejuen, Lim Zhengjie, Malhotra Atul
Monash Health, Melbourne.
Ballarat Health Services, Ballarat.
Blood Coagul Fibrinolysis. 2019 Apr;30(3):104-110. doi: 10.1097/MBC.0000000000000802.
: Thrombocytopenia has been closely associated with small-for-gestational-age neonates (SGA; birthweight less than tenth percentile) admitted to the special care nursery or neonatal ICU. It is unclear if 'well' SGA neonates experience the same incidence of thrombocytopenia in the SGA population as compared to sick neonates. We conducted a retrospective cohort study from a health network in Melbourne, Australia, between 2012 and 2015 to identify SGA neonates (≥ 35 weeks' gestation at birth) that were otherwise well. Neonates with at least one platelet count within 7 days of life were matched to appropriate-for-gestational-age (AGA) neonates from the same birth centre, with the same sex, and closest gestational age and birth date, who were also considered otherwise well. 16.7% of matched neonates had thrombocytopenia (303/1814) and of these, a larger proportion of SGA neonates were thrombocytopenic, 21.7% (197/907), than AGA neonates, 11.7% (106/907, P < 0.01). The incidence of thrombocytopenia was greater in the SGA cohort regardless of admission destination (special care nursery/neonatal ICU 26.8 vs. 13.9%, P < 0.01; Postnatal Ward 16.5 vs. 9.4%, P < 0.01). Thrombocytopenia is more prevalent amongst constitutionally well SGA neonates than AGA neonates. SGA alone increases the risk of thrombocytopenia.
血小板减少症与入住特殊护理病房或新生儿重症监护病房的小于胎龄新生儿（SGA；出生体重低于第十百分位数）密切相关。目前尚不清楚与患病新生儿相比，“健康”的小于胎龄新生儿在小于胎龄人群中血小板减少症的发生率是否相同。我们对澳大利亚墨尔本一个健康网络在2012年至2015年期间进行了一项回顾性队列研究，以确定出生时胎龄≥35周且其他方面健康的小于胎龄新生儿。将出生后7天内至少有一次血小板计数的新生儿与来自同一出生中心、性别相同、胎龄和出生日期最接近且同样被认为其他方面健康的适于胎龄（AGA）新生儿进行匹配。16.7%的匹配新生儿患有血小板减少症（303/1814），其中，小于胎龄新生儿血小板减少的比例更高，为21.7%（197/907），高于适于胎龄新生儿的11.7%（106/907，P<0.01）。无论入住目的地如何（特殊护理病房/新生儿重症监护病房，26.8%对13.9%，P<0.01；产后病房，16.5%对9.4%，P<0.01），小于胎龄队列中血小板减少症的发生率更高。在体质健康的小于胎龄新生儿中，血小板减少症比适于胎龄新生儿更普遍。仅小于胎龄这一因素就增加了血小板减少症的风险。
