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      Effect of Gestational Age, Prematurity and Birth Asphyxia on Platelet Indices in Neonates

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          Abstract

          Context:

          Platelet indices are useful markers of platelet maturity and function and can be used for the early diagnosis of thromboembolic disorders. Prematurity, birth asphyxia (BA) and small for gestational age (SGA) babies have been associated with increased risk of hemostatic abnormalities.

          Aims:

          The aim was to study the platelet indices in prematuriy, SGA, and BA newborns.

          Settings and Design:

          The type of this study is Prospective study.

          Materials and Methods:

          Blood samples from 253 newborns were collected in K2EDTA (Becton Dickenson, USA) tubes within 24 h of birth. The following parameters were studied - platelet count, mean platelet volume (MPV), plateletcrit (PCT) and platelet distribution width (PDW). Data regarding the neonatal physiological status with respect to prematurity, gestational age and BA were collected. Statistical Analysis Used: The statistical analysis was performed on the entire sample used was mean, standard deviation and one-way ANOVA. P <0.05 was considered as significant.

          Results:

          The average platelet count in preterm, SGA, and BA newborn was significantly lower than the average platelet count in controls. MPV averaged 8.29 fL, 8.16 fL, and 8.35 fL in preterm, SGA and BA neonate, respectively and was significantly increased. PCT was 0.18% in preterm, SGA and in BA. Though, the difference was not statistically significant. PDW was significantly increased in preterm, SGA, and BA newborns when compared with controls.

          Conclusions:

          MPV, PDW was significantly increased in SGA, premature and BA newborns, which may be due to platelet activation. Platelet indices may provide to be a useful marker of thromboembolic status in newborns.

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          Most cited references19

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          Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis.

          To determine whether an association exists between mean platelet volume (MPV) and acute myocardial infarction (AMI) and other cardiovascular events. Platelet activity is a major culprit in atherothrombotic events. MPV, which is widely available in clinical practice, is a potentially useful biomarker of platelet activity in the setting of cardiovascular disease. We performed a systematic review and meta-analysis investigating the association between MPV and AMI, all-cause mortality following myocardial infarction, and restenosis following coronary angioplasty. Results were pooled using random-effects modeling. Pooled results from 16 cross-sectional studies involving 2809 patients investigating the association of MPV and AMI indicated that MPV was significantly higher in those with AMI than those without AMI [mean difference 0.92 fL, 95% confidence interval (CI) 0.67-1.16, P < 0.001). In subgroup analyses, significant differences in MPV existed between subjects with AMI, subjects with stable coronary disease (P < 0.001), and stable controls (P < 0.001), but not vs. those with unstable angina (P = 0.24). Pooled results from three cohort studies involving 3184 patients evaluating the risk of death following AMI demonstrated that an elevated MPV increased the odds of death as compared with a normal MPV (11.5% vs. 7.1%, odds ratio 1.65, 95% CI 1.12-2.52, P = 0.012). Pooled results from five cohort studies involving 430 patients who underwent coronary angioplasty revealed that MPV was significantly higher in patients who developed restenosis than in those who did not develop restenosis (mean difference 0.98 fL, 95% CI 0.74-1.21, P < 0.001). Elevated MPV is associated with AMI, mortality following myocardial infarction, and restenosis following coronary angioplasty. These data suggest that MPV is a potentially useful prognostic biomarker in patients with cardiovascular disease. Whether the relationship is causal, and whether MPV should influence practice or guide therapy, remains unknown.
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            Platelet distribution width: a simple, practical and specific marker of activation of coagulation.

            Platelet indices are potentially useful markers for the early diagnosis of thromboembolic diseases. An increase in both mean platelet volume (MPV) and platelet distribution width (PDW) due to platelet activation, resulting from platelet swelling and pseudopodia formation was hypothesized. Platelet indices (MPV and PDW) in three groups of persons, using impedance and optical technology were measured. The first group consisted of patients with established platelet activation and healthy control subjects. The second study group included pregnant women in different trimesters of pregnancy. The effect of storage time on MPV and PDW in blood samples of a third group of randomly chosen patients was also assessed. There was a significant increase in MPV (P<0.001) and PDW (P<0.001) in patients with confirmed platelet activation compared to healthy control subjects. Only PDW showed a significant increase from the first to the third trimester of pregnancy (P=0.009). Temporal changes of MPV and PDW over storage time revealed a significant increase in MPV (P<0.001), in contrast to a significant decrease in PDW (P<0.05). MPV and PDW are simple platelet indices, which increase during platelet activation. PDW is a more specific marker of platelet activation, since it does not increase during simple platelet swelling.
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              • Article: not found

              The molecular mechanisms that control thrombopoiesis.

              Our understanding of thrombopoiesis--the formation of blood platelets--has improved greatly in the last decade, with the cloning and characterization of thrombopoietin, the primary regulator of this process. Thrombopoietin affects nearly all aspects of platelet production, from self-renewal and expansion of HSCs, through stimulation of the proliferation of megakaryocyte progenitor cells, to support of the maturation of these cells into platelet-producing cells. The molecular and cellular mechanisms through which thrombopoietin affects platelet production provide new insights into the interplay between intrinsic and extrinsic influences on hematopoiesis and highlight new opportunities to translate basic biology into clinical advances.
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                Author and article information

                Journal
                J Clin Neonatol
                J Clin Neonatol
                JCN
                Journal of Clinical Neonatology
                Medknow Publications & Media Pvt Ltd (India )
                2249-4847
                1658-6093
                Jul-Sep 2014
                : 3
                : 3
                : 144-147
                Affiliations
                [1] Department of Pathology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
                [1 ] Department of Pediatrics, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
                [2 ] Department of Gynaecology, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka, India
                Author notes
                Address for correspondence: Dr. Vidyavathi Kannar, Dhanvantari Polyclinic, Kolar, Karnataka, India. E-mail: vidyaraj74@ 123456rediffmail.com
                Article
                JCN-3-144
                10.4103/2249-4847.140399
                4201247
                294a9396-5697-49a3-9bbf-2516f9a6908e
                Copyright: © Journal of Clinical Neonatology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Categories
                Original Article

                birth asphyxia,neonates,platelet indices,prematurity,small for gestational age

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