Background: Neonatal Thrombocytopenia (NT) is defined as a platelet count of <150,000/microL and is classified as: Mild (platelet count 100,000- 149,000/microL), moderate (50,000- 99,000/microL), and Severe (<50,000/microL).  It is classified according to the time of presentation as: Early NT (occurs within the first 72 hours of life) and Late NT (occurs after 72 hours).
Objectives: To study the clinical and laboratory profiles of neonatal thrombocytopenia in the Neonatal Intensive Care Unit of the Children Welfare Teaching Hospital, Baghdad.
Methods: This single-center case series observational study was conducted from 1^st May 2022 to 30^th April 2023, in the Neonatal Intensive Care Unit of the Children Welfare Teaching Hospital, Baghdad. Neonates with thrombocytopenia, defined as a platelet count <150,000/µL, were enrolled. Complete blood count, C-reactive protein, blood culture, and other investigations were performed as clinically indicated. Data were analyzed using IBM SPSS version 29. Categorical variables were analyzed using the Pearson chi-square test or Fisher’s exact test, as appropriate, and a P-value of <0.05 was considered statistically significant.
Results: Among the 1701 neonates admitted to the NICU, 107 (6.3%) developed neonatal thrombocytopenia. Mild thrombocytopenia was the most common category, occurring in 57 cases (53.3%), followed by moderate thrombocytopenia in 36 (33.6%) and severe thrombocytopenia in 14 (13.1%). Out of the total cases, there were more preterm 61 (57.0%) than full term neonates 46 (43.0%). Sepsis was the most common associated condition, identified in 53 cases (49.6%), followed by asphyxia in 11 cases (10.3%). Severe thrombocytopenia was significantly associated with hemoglobin <15 g/dL (P=0.04), bleeding from venipuncture and cannula sites (P=0.034), and death (P=0.0001).
Conclusion: Neonatal thrombocytopenia was found to be common in this study cohort, with sepsis being the leading associated condition. Severe cases seem to be linked to bleeding manifestations, anemia, and mortality, which highlight the importance of careful monitoring of affected neonates.