Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

The effects of maternal hypertension on the early neonatal platelet count

Journal of Perinatology volume 42, pages 796–802 (2022)Cite this article

Subjects

Abstract

Objective

To examine the relationship between maternal hypertension and early neonatal platelet counts.

Study design

This single site retrospective cohort study compared initial platelet counts in the first day of life of infants born to mothers with preeclampsia with severe features (PSF) (n = 224) and infants born to normotensive mothers using multivariable logistic and Quasi-Poisson regression models.

Result

There was no statistical difference in initial platelet counts or likelihood of thrombocytopenia (aOR = 1.19, 95% CI 0.68–2.08) between infants born to mothers with PSF and infants born to normotensive mothers after multivariable adjustment. Initial platelet counts and thrombocytopenia risk were unaffected by the presence of maternal end organ dysfunction. Small for gestational age (SGA) status was the most significant risk factor for the development of thrombocytopenia (aOR = 2.24, 95% CI 1.13–4.30).

Conclusion

Maternal PSF does not directly affect neonatal initial platelet counts. SGA status confers the greatest risk of early thrombocytopenia.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Legend: box plot showing the distribution of initial platelet counts in the SGA, non-SGA, hypertension, and control groups.

Similar content being viewed by others

References

  1. Sola-Visner M, Saxonhouse MA, Brown RE. Neonatal thrombocytopenia: what we do and don’t know. Early Hum Dev. 2008;84:499–506.

    Article  Google Scholar 

  2. Roberts I, Murray NA. Neonatal thrombocytopenia: causes and management. Arch Dis Child Fetal Neonatal Ed. 2003;88:359–64.

    Article  Google Scholar 

  3. Christensen RD, Baer VL, Henry E, Snow GL, Butler A, Sola-Visner MC. Thrombocytopenia in small-for-gestational-age infants. Pediatrics 2015;136:e361–70.

    Article  Google Scholar 

  4. Christensen RD, Henry E, Wiedmeier SE, Stoddard RA, Sola-Visner MC, Lambert DK, et al. Thrombocytopenia among extremely low birth weight neonates: data from a multihospital healthcare system. J Perinatol. 2006;26:348–53.

    Article  CAS  Google Scholar 

  5. Kahn DJ, Richardson DK, Billett HH. Inter-NICU variation in rates and management of thrombocytopenia among very low birth-weight infants. J Perinatol. 2003;23:312–6.

    Article  Google Scholar 

  6. Baer VL, Lambert DK, Henry E, Christensen RD. Severe thrombocytopenia in the NICU. Pediatrics.2009;124:e1095–100.

    Article  Google Scholar 

  7. Stanworth SJ, Clarke P, Watts T, Ballard S, Choo L, Morris T, et al. Prospective, observational study of outcomes in neonates with severe thrombocytopenia. Pediatrics.2009;124:e826–34.

    Article  Google Scholar 

  8. McPherson RJ, Juul SE. Patterns of thrombocytosis and thrombocytopenia in hospitalized neonates. J Perinatol. 2005;25:166–72.

    Article  Google Scholar 

  9. Roberts IAG, Murray NA. Neonatal thrombocytopenia. Semin fetal adn Neonatal Med. 2008;13:256–64.

    Article  Google Scholar 

  10. Fraser SH, Tudehope DI. Neonatal neutropenia and thrombocytopenia following maternal hypertension. J Paediatr Child Health. 1996;32:31–4.

    Article  CAS  Google Scholar 

  11. Brazy JE, Grimm JK, Little VA. Neonatal manifestations of severe maternal hypertension occurring before the thirty-sixth week of pregnancy. J Pediatr. 1982;100:265–71.

    Article  CAS  Google Scholar 

  12. Bolat A, Gursel O, Kurekci E, Atay A, Ozcan O. Blood parameters changes in cord blood of newborns of hypertensive mothers. Eur J Pediatr. 2013;172:1501–9.

    Article  CAS  Google Scholar 

  13. Akcan AB, Oygucu SE, Ozel D, Oygür N. Mean platelet volumes in babies of preeclamptic mothers. Blood Coagul Fibrinolysis. 2011;22:285–7.

    Article  CAS  Google Scholar 

  14. Al-Bahadily A-KJM, Al-Omrani AA-AM, Mohammed M. The effect of pregnancy induced hypertension on complete blood count of Newborn. Int J Pediatr. 2017;5:5667–76.

    CAS  Google Scholar 

  15. Samuels P, Main E, A T, Mennuti M, Gabbe S, Cines D. Abnormalities in platelet antiglobulin tests in preeclamptic mothers and their neonates. Am J Obstet Gynecol. 1987;157:109–13.

    Article  CAS  Google Scholar 

  16. Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inf. 2009;42:377–81.

    Article  Google Scholar 

  17. Harris PA, Taylor R, Minor BL, Elliott V, Fernandez M, O’Neal L, et al. The REDCap consortium: building an international community of software platform partners. J Biomed Inform. 2019;95:103208.

    Article  Google Scholar 

  18. Hypertension G. Gestational hypertension and preeclampsia: ACOG practice bulletin summary, number 222. Obstet Gynecol. 2020;135:1492–5.

    Article  Google Scholar 

  19. Pritchard JA, Gary Cunningham F, Pritchard SA, Mason RA. How often does maternal preeclampsia-eclampsia incite thrombocytopenia in the fetus?. Obstet Gynecol. 1987;69:292–5.

    CAS  PubMed  Google Scholar 

  20. Matsubara K, Fukaya T, Nigami H, Harigaya H, Hirata T, Nozaki H, et al. Age-dependent changes in the incidence and etiology of childhood thrombocytosise. Acta Haematol. 2004;111:132–7.

    Article  Google Scholar 

  21. Fustolo-Gunnink SF, Vlug RD, Heckman EJ, Pas AB, Fijnvandraat K, Lopriore E. Early-onset thrombocytopenia in small-for-gestational-age neonates: a retrospective cohort study. PLoS One. 2016;11:1–10.

    Article  Google Scholar 

  22. Duley L. The global impact of pre-eclampsia and eclampsia. Semin Perinatol [Internet]. 2009;33:130–7. https://doi.org/10.1053/j.semperi.2009.02.010.

    Article  Google Scholar 

  23. Zeitlin JA, Ancel PY, Saurel-Cubizolles MJ, Papiernik E. Are risk factors the same for small for gestational age versus other preterm births? Am J Obstet Gynecol. 2001;185:208–15.

    Article  CAS  Google Scholar 

  24. Meberg A, Halvorsen S, Ørstavik I. Transitory thrombocytopenia in small-for-dates infants, possibly related to maternal smoking. Lancet [Internet]. 1977;310:303–4. https://linkinghub.elsevier.com/retrieve/pii/S0140673677909916.

    Article  Google Scholar 

  25. Lee E, Lim Z, Malhotra A. Thrombocytopenia in well small for gestational age neonates. Blood Coagul Fibrinolysis. 2019;30:104–10.

    Article  Google Scholar 

  26. Beiner ME, Simchen MJ, Sivan E, Chetrit A, Kuint J, Schiff E. Risk factors for neonatal thrombocytopenia in preterm infants. Am J Perinatol. 2003;20:049–54.

    Article  Google Scholar 

  27. Watts T, Roberts IAG. Haematological abnormalities in the growth-restricted infant. Semin Neonatol. 1999;4:41–54.

    Article  Google Scholar 

  28. Shuper A, Mimouni F, Merlob P, Zaizov R, Reisner S. Thrombocytopenia in small‐for‐gestational‐age infants. Acta Paediatr. 1983;72:139–40.

    Article  CAS  Google Scholar 

  29. Murray NA, Roberts IAG. Circulating megakaryocytes and their progenitors in early neonatal thrombocytopenia. Pediatr Res. 1996;40:112–9.

    Article  CAS  Google Scholar 

  30. Sola MC, Calhoun DA, Hutson AD, Christensen RD. Plasma thrombopoietin concentrations in thrombocytopenic and non- thrombocytopenic patients in a neonatal intensive care unit. Br J Haematol. 1999;104:90–2.

    Article  CAS  Google Scholar 

  31. Cremer M, Weimann A, Schmalisch G, Hammer H, Bührer C, Dame C. Immature platelet values indicate impaired megakaryopoietic activity in neonatal early-onset thrombocytopenia. Thromb Haemost. 2010;103:1016–21.

    Article  CAS  Google Scholar 

  32. Curley A, Stanworth SJ, Willoughby K, Fustolo-Gunnink SF, Venkatesh V, Hudson C, et al. Randomized trial of platelet-transfusion thresholds in neonates. N Engl J Med. 2018;380:242–51.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics Division of Neonatology, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA

    Peter Joslyn & Brian Barkemeyer

  2. Biostatistics Program, School of Public Health, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA

    Cornelius Rosenbaum & Andrew G. Chapple

  3. Department of Obstetrics and Gynecology Division of Maternal Fetal Medicine, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA

    Asha Heard

  4. Department of Pediatrics Division of Hematology Oncology, Louisiana State University Health Sciences Center New Orleans, New Orleans, LA, USA

    Maria Velez

Authors
  1. Peter Joslyn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cornelius Rosenbaum
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Andrew G. Chapple
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Asha Heard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maria Velez
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Brian Barkemeyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

BB, AC, AH, PJ, and MV planned and designed the study. PJ performed data collection. AC and CR performed statistical analysis. PJ wrote the first draft of the manuscript. BB, AC, AH, CR, and MV revised the manuscript.

Corresponding author

Correspondence to Peter Joslyn.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Joslyn, P., Rosenbaum, C., Chapple, A.G. et al. The effects of maternal hypertension on the early neonatal platelet count. J Perinatol 42, 796–802 (2022). https://doi.org/10.1038/s41372-021-01278-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-021-01278-1

This article is cited by

Search

Advanced search

Quick links