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Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis



In order to conclude on the megakaryopoietic activity during thrombocytopenia in sepsis or necrotizing enterocolitis (NEC), we analyzed the immature platelet fraction (IPF).

Study design:

Serial measurements of platelet counts and IPF in neonates with blood culture-proven late-onset sepsis (n=21) or surgical NEC (n=12) at T0: prior to the diagnosis of sepsis/NEC; T1: at diagnosis; T2: days 3 to 5 after onset; T3: days 8 to 12 after onset.


In parallel to declining platelet counts, the median absolute IPF significantly decreased between T0 and T2 in neonates with sepsis or NEC. We found a significant positive correlation between the platelet count and absolute IPF (r=0.71; P<0.001). In patients with low IPF (<2 per nl), the platelet count did not subsequently increase. Neonates with NEC who died exhibited significantly lower IPF compared with survivors (P<0.05).


Low absolute IPF values during the course of neonatal sepsis/NEC suggest suppression of megakaryopoietic activity.

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We thank Reinhold Schiller, MD, Institute for Microbiology, Charité, for technical assistance and Jessica Blank for secretary support.

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Correspondence to M Cremer.

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Cremer, M., Weimann, A., Szekessy, D. et al. Low immature platelet fraction suggests decreased megakaryopoiesis in neonates with sepsis or necrotizing enterocolitis. J Perinatol 33, 622–626 (2013).

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  • thrombocytopenia
  • platelet transfusion
  • mean platelet volume
  • nucleated red blood cells
  • erythroblast

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