Survival status and predictors of mortality among thrombocytopenic neonates admitted at comprehensive specialized hospital neonatal intensive care units in East Amhara, Ethiopia, 2023 a multi-center prospective follow-up study.

BACKGROUND

Thrombocytopenia, defined as a platelet count of less than 150 × 109/L of blood, is one of the most commonly encountered hematological disorders in sick newborn infants globally. This is a major concern, especially in resource-constrained countries like Ethiopia. Given the significant burden of neonatal thrombocytopenia, gathering current research on factors that predict mortality and survival status is critical to address this issue. However, there is a scarcity of information regarding neonatal thrombocytopenia in the specific study area.

OBJECTIVE

To assess survival status and predictors of mortality among thrombocytopenic neonates admitted to comprehensive specialized hospital neonatal intensive care units (NICUs) in Ethiopia.

METHODOLOGY: A multi-center, institution-based prospective follow-up study was conducted among 302 thrombocytopenic neonates admitted to NICUs in East Amhara, Ethiopia, from August 2022 to March 2023. The neonates were followed for up to 28 days, with data collected using a structured tool and analyzed using STATA software. Kaplan-Meier survival curves, log-rank tests, and Weibull regression were used to determine survival time differences and predictors of mortality, with statistical significance set at p < 0.05.

RESULT: Overall, 21.9% (61/278) of the thrombocytopenic neonates died, and the median time to death was 22 days (IQR: 15, 28). Significant predictors for time to death of thrombocytopenic neonates were male sex [adjusted hazard ratio (AHR): 2.2; 95% CI: 1.19-4.04], birth weight (β: 0.99; 95% CI: 0.98-0.99), episode of thrombocytopenia (β: 1.16; 95% CI: 1.01-1.34), late-onset thrombocytopenia (AHR: 2.23; 95% CI: 1.01-4.55), necrotizing enterocolitis (AHR: 2.0; 95% CI: 1.04-3.85), and low 5th minute Apgar score (AHR: 2.03; 95% CI: 1.02-4.02).

CONCLUSION

These findings highlight the association between the aforementioned factors and higher mortality rates in thrombocytopenic neonates, emphasizing the need for further research to understand the underlying mechanisms and develop effective interventions to improve outcomes.