A STUDY TO ASSESS EFFECT ON PLATELET AND PLATELET INDICES IN NEONATAL SEPSIS

Abstract

Aims and objectives :To assess whether Platelet Parameters: Total platelet count (TPC), Mean platelet volume (MPV), Platelet distribution width (PDW)and the ratio of MPV/TPC can serve as diagnostic markers in neonatal sepsis

Materials and method: This observational study was conducted in the Department of Paediatrics at Maharshi Markandeshwar Institute of Medical Sciences and Research, Mullana, District Ambala, Haryana, over a period of one year and six months from April 2024 to October 2025. The study population comprised of 150 neonates diagnosed with sepsis and admitted to the neonatal unit during the study period. Convenience sampling was employed to recruit eligible participants. Blood samples were collected under strict aseptic precautions at the time of sepsis evaluation. Complete blood count, including platelet count and platelet indices, was performed simultaneously with blood culture sampling. Peripheral blood smear examination and C-reactive protein (CRP) estimation were performed for all neonates, with CRP levels >1 mg/L considered indicative of neonatal sepsis. An absolute neutrophil count (ANC) <1500/mm³ was considered abnormal. Blood cultures were processed according to standard microbiological protocols, while additional investigations, including cerebrospinal fluid culture, urine culture, and other body fluid cultures, were carried out whenever clinically indicated. Neonates aged less than 28 days at the time of admission who had either a positive sepsis screen or culture-proven sepsis were included in the study. Neonates and mothers with hematological disorders, neonates with major congenital anomalies or chromosomal disorders, and neonates born to mothers receiving antiplatelet medications were excluded.

Results: Platelet count was significantly lower in fungal sepsis (p value 0.041), while platelet distribution width (PDW) (p value 0.01) and the mean platelet volume/platelet count (MPV/TPC) ratio ( p value 0.004) were significantly higher in fungal sepsis .MPV/TPC ratio demonstrated the highest diagnostic accuracy for predicting mortality (AUC = 0.918), followed by PDW (AUC = 0.872) and platelet count (AUC = 0.868), whereas MPV showed the best predictive ability for the onset of sepsis EONS vs LONS (AUC = 0.732). PDW and MPV/TPC were more significantly elevated than thrombocytopenia and MPV in fungal sepsis. Acinetobacter baumannii featured as most common cause of sepsis in both early-onset neonatal sepsis (EONS) and late-onset neonatal sepsis (LONS) . Candida albicans appearing as a cause of EONS further warns antibiotic stewardship as the need of the hour.

Conclusion: Platelet indices, particularly mean platelet volume (MPV), platelet distribution width (PDW), and the MPV/platelet count (MPV/TPC) ratio, are simple, rapid, inexpensive, and readily available biomarkers that may serve as useful adjuncts in the diagnosis and prognostication of neonatal sepsis when interpreted alongside clinical assessment and other laboratory findings.