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Am J Perinatol
DOI: 10.1055/a-2053-7759
Original Article

Platelet Indices: Universally Available Clinical Adjunct for Diagnosing Necrotizing Enterocolitis

Yair Kasirer
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Irina Shchors
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
,
Cathy Hammerman 
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
2   Faculty of Medicine, Department of Pediatrics, The Hebrew University, Jerusalem, Israel
,
Alona Bin-Nun
1   Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel
2   Faculty of Medicine, Department of Pediatrics, The Hebrew University, Jerusalem, Israel
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Abstract

Objective Platelet function parameters can be predictive of several adult diseases and their severity. However, few studies report on the association between platelet indices and neonatal diseases, specifically necrotizing enterocolitis (NEC). The objective of this study is to investigate whether platelet indices are associated with NEC diagnosis and NEC-related mortality.

Study Design We retrospectively examined records from infants admitted to the neonatal intensive care unit with a diagnosis of NEC, verified by the presence of pneumatosis on X-ray or pathology at surgery. We compared them with an age-matched group of prematures without NEC. We investigated platelet count, mean platelet volume (MPV), platelet distribution width and red cell distribution width to platelet ratio (RPR) and delta platelets from birth to the time of NEC diagnosis or day of life 14 in the control group.

Results Sixty-nine infants with NEC and 78 control infants were studied. Basic sociodemographic data were similar in both groups. All platelet parameters measured—except for MPV—were significantly associated with NEC diagnosis. Although MPV was not associated with the diagnosis of NEC (p = 0.800), it was significantly associated with NEC-related mortality (p < 0.001). Only total platelet count and RPR were significantly associated with both NEC diagnosis (p < 0.0001) and mortality (p = 0.04 and 0.01, respectively). On multivariable analysis only the change in platelet count from birth to time of diagnosis remained significant.

Conclusion While not definitive, this study demonstrates that these routinely available, inexpensive, and easily calculated platelet indices can provide a clinical adjunct in the often-elusive attempts to definitively diagnose NEC in preterm neonates.

Key Points

  • Platelet indices were associated with NEC diagnosis.

  • MPV was predictive of NEC-related mortality.

  • Delta platelet count from birth was significantly related to NEC diagnosis.

Keywords

necrotizing enterocolitis - platelet indices - preterm neonates


Publication History

Received: 30 March 2022

Accepted: 24 February 2023

Accepted Manuscript online:
14 March 2023

Article published online:
10 April 2023

© 2023. Thieme. All rights reserved.

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