Variation of platelet parameters in preterm neonates

Chandrakala P., Krithika G. S.


Background: Platelets play a crucial role in hemostasis and phagocytosis. These functions of platelets are acquired gradually from foetal life to infant life. Larger, immature platelets are more reactive and hence platelet mass indices may be indicative of the thrombotic potential of platelets.

Methods: This study was conducted in Kempegowda institute of medical sciences and research centre attached hospital in Bengaluru, Karnataka, India between January, 2019 and July, 2020. Platelet count, mean platelet volume (MPV), platelet distribution width (PDW) was obtained from automated analyzer reports (SYSMEX XT 1800i). The statistical association between the gestational age, birth weight and gender of preterm and their platelet parameters, was then assessed.

Results: In this study, the effect of gestational age, birth weight and gender on platelet parameters was studied. A significant correlation between PDW (platelet distribution width), MPV (mean platelet volume) and gestational age was found. It was found that with increasing gestational age, both PDW and MPV decreased. With respect to birth weight, the mean, median PDW significantly decreased with increasing birth weight. None of the platelet parameters were different between male and female preterm neonates.

Conclusions: There still remains a paucity of studies regarding the correlation between platelet mass indices and gestational age and birth weight. While some studies show positive correlation, some studies show no correlation and this study shows negative correlation. Hence, this calls for more studies, with larger sample sizes, to be undertaken.


Platelet, PDW, MPV, Preterm, Gestational age, Birth weight

Full Text:



Sola-Visner M. Platelets in the neonatal period: Developmental differences in platelet production, function, and hemostasis and the potential impact of therapies. Hematol Am Soc Hematol Educ Program. 2012;2012:506-11.

Israels SJ, Rand ML, Michelson AD. Neonatal platelet function. Semin Thromb Hemost. 2003;29:363-72.

Strauss T, Sidlik-Muskatel R, Kenet G. Developmental hemostasis: Primary hemostasis and evaluation of platelet function in neonates. Semin Fetal Neonatal Med. 2011;16:301-4.

Mehta P, Vasa R, Neumann L, Karpatkin M. Thrombocytopenia in the high-risk infant. J Pediatr. 1980;97:791-4.

Roberts IA, Murray NA. Thrombocytopenia in the newborn. Curr Opin Pediatr. 2003;15:17-23.

Aman I, Hassan KA, Ahmad TM. The study of thrombocytopenia in sick neonates. J Coll Physicians Surg Pak. 2004;14:282-5.

Hussein NF, Helaly NS, Ghanya EA, Anisb SK. Relationship between Mean Platelet Volume and Bronchopulmonary Dysplasia and Intraventricular Hemorrhage in Very Low Birth Weight Neonates. J Am Sci. 2012;8:5.

Nourripoor S, Tabasizadeh H, Afjehi A, Ghorbani R, Seifhashemi M, Masoudian N. Could mean platelet volume predict developing of bronchopulmonary dysplasia in preterm infants with respiratory distress syndrome? Iran J Neonatol. 2013;4(3):35-41.

Kaushansky K, Roth GJ. Platelets and megakaryocytes. In: Greer JP, Forester J, Luken J, Rodgers GM, Paraskevas F, Glader B (eds). Wintrobe’s Clinical Hematology. Lippincott Williams and Wilkins: Philadelphia, PA, 2004;605-50.

Wiedmeier S, Henry E, Sola-Visner M, Christensen R. Platelet reference ranges for neonates, defined using data from over 47 000 patients in a multihospital healthcare system. J Perinatol. 2008;29(2):130-6.

Van den Hof MC, Nicolaides KH. Platelet count in normal, small, and anemic fetuses. Am J Obstet Gynecol. 1990;162(3):735-9.

Forestier F, Daffos F, Galacteros F, Bardakjian J, Rainaut M, Beuzard Y. Hematological values of 163 normal fetuses between 18 and 30 weeks of gestation. Pediatr Res. 1986;20(4):342-6.

Forestier F, Daffos F, Catherine N, Renard M, Andreux J-P. Developmental hematopoiesis in normal human fetal blood. Blood. 1991;77(11):2360-3.

Hohlfeld P, Forestier F, Kaplan C, Tissot J-D, Daffos F. Fetal thrombocytopenia: a retrospective survey of 5,194 fetal blood samplings. Blood. 1994;84(6):1851-6.

McPherson RJ, Juul S. Patterns of thrombocytosis and thrombocytopenia in hospitalized neonates. J Perinatol. 2005;25(3):166-72.

Patrick CH, Lazarchick J. The effect of bacteremia on automated platelet measurements in neonates. Am J Clin Pathol. 1990;93(3):391-4.

Arad ID, Alpan G, Sznajderman SD, Eldor A. The mean platelet volume (MPV) in the neonatal period. Am J Perinatol. 1986;3(1):1-3.

Kaushansky K. Thrombopoietin. N Engl J Med. 1998;339:746-54.

Walka MM, Sonntag J, Dudenhausen JW, Obladen M. Thrombopoietin concentrations in umbilical cord of healthy term newborns is higher than in adult controls. Biol Neonate. 1999;75(1):54-8.

Sola MC, Juul SE, Meng YG, Garg S, Sims P, Calhoun DA et al. Thrombopoietin (Tpo) in the fetus and neonate: Tpo concentration in preterm and term neonates, and organ distribution of Tpo and its receptor (c-mpl) during human fetal development. Early Hum Dev. 1999;53(3):239-50.

Ishiguro A, Nakahata T, Matsubara K, Hayashi Y, Kato T, Suzuki Y et al. Age-related changes in thrombopoietin levels. Br J Haematol. 1999;106:884-8.

Patrick CH, Lazarchick J, Stubbs T, Pittard WB. Mean platelet volume and platelet distribution width in the neonate. Am J Pediatr Hematol Oncol. 1987;9:130-2.

Park Y, Schoene N, Harris W. Mean platelet volume as an indicator of platelet activation: Methodological issues. Platelets. 2002;13:301-6.