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The immature platelet fraction: creating neonatal reference intervals and using these to categorize neonatal thrombocytopenias

Journal of Perinatology volume 37, pages 834–838 (2017)Cite this article

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Abstract

Objective:

The immature platelet fraction (IPF) is a laboratory measurement analogous to the reticulocyte count, but reflecting the thrombopoietic state. Similar to a reticulocyte count, it can be expressed as a percent (IPF%=percent of platelets that are immature) or as an absolute number per μl blood; the immature platelet count (IPC=IPF% × platelets per μl of blood).

Study design:

Using a retrospective analysis of de-identified data from non-thrombocytopenic neonates, we created reference intervals for IPF% and IPC. We then tested the value of these measurements for categorizing thrombocytopenic neonates.

Results:

New charts display reference intervals for IPF% and IPC on the day of birth according to gestational age, and during the first 90 days after birth. Neonates with hyporegenerative varieties of thrombocytopenias (syndromes, small for gestational age, birth asphyxia) had lower IPF% and IPC than did neonates with consumptive thrombocytopenias (immune-mediated, infection, disseminated intravascular coagulation, necrotizing enterocolitis; both P<0.0001).

Conclusion:

The new reference interval charts can be used to recognize abnormal IPFs. The IPF parameters can help clarify the kinetic mechanism responsible for thrombocytopenias in neonates.

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Acknowledgements

We thank laboratory staff members Robert Childs, Dereck Daniels, Rachael Ethington, Dave Garner, Laurie Jeffs, Jennessa Jessop, Heather Kuusela, Tyson Olson, Chris Partington, Tim Patten, Brooke Qi, Lauralyn Ragin, Tara Regginello, Aba Saunders, Alicia Simon, Jennifer Sorenson, Lia Souza, Tom Taylor and Ashley Windsor for extracting data from the hematology analyzers. This study was supported in part by grant P01 HL046925 from the US Public Health Service (MCS-V).

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    B C MacQueen & R D Christensen

  2. Women and Newborn’s Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA

    R D Christensen, E Henry & A M Romrell

  3. Department of Pediatrics, Division of Hematology/Oncology, University of Utah School of Medicine, Salt Lake City, UT, USA

    R D Christensen

  4. Institute for Healthcare Delivery Research, Salt Lake City, UT, USA

    E Henry

  5. Department of Pathology, University of Utah School of Medicine, Primary Children’s Hospital, Salt Lake City, UT, USA

    T J Pysher

  6. Department of Pathology, Intermountain Medical Center, Murray, UT, USA

    S T Bennett

  7. Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA

    S T Bennett

  8. Division of Newborn Medicine, Boston Children’s Hospital and Harvard Medical School, Boston, MA, USA

    M C Sola-Visner

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  1. B C MacQueen
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  2. R D Christensen
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  3. E Henry
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  7. M C Sola-Visner
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Corresponding author

Correspondence to B C MacQueen.

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Competing interests

MCS-V has a Sysmex Veterinary Analyzer as a loan from Sysmex America. She does not receive any financial support from Sysmex. The remaining authors declare no conflicts of interest.

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MacQueen, B., Christensen, R., Henry, E. et al. The immature platelet fraction: creating neonatal reference intervals and using these to categorize neonatal thrombocytopenias. J Perinatol 37, 834–838 (2017). https://doi.org/10.1038/jp.2017.48

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  • DOI: https://doi.org/10.1038/jp.2017.48

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