Platelet Counts and Patent Ductus Arteriosus in Preterm Infants: A Systematic Review and Meta-Analysis

• Published in: Neonatology (Basel, Switzerland) Vol. 108; no. 2; pp. 143 - 151
• Main Authors: Simon, Sorina R., van Zogchel, Lieke, Bas-Suárez, Maria Pilar, Cavallaro, Giacomo, Clyman, Ronald I., Villamor, Eduardo
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2015
• Subjects: Blood cell count; Diagnosis; Ductus Arteriosus, Patent - epidemiology; Gestational Age; Humans; Infant, Extremely Premature; Infant, Newborn; Medical examination; Patent ductus arteriosus; Pediatric research; Platelet Count; Premature infants; Risk Factors; Systematic Review and Meta-Analysis; Netherlands; Platelets; Ductus arteriosus; Meta-analysis
• ISSN: 1661-7800; 1661-7819
• DOI: 10.1159/000431281

Background: Several cohort studies have shown an association between low platelet counts in the first day(s) of life and patent ductus arteriosus (PDA) in preterm infants. However, these results have not been confirmed by other studies. Objective: To perform a meta-analysis of all the studies addressing the relationship between platelet counts in the first day(s) of life and PDA in preterm infants. Methods: PubMed/MEDLINE and EMBASE were searched from their inception until December 2014. Results from 11 cohort studies involving 3,479 preterm infants (gestational age <32 weeks) were pooled using random-effects modeling. Results: Meta-analysis showed a significant positive association between PDA and platelet counts <150 × 10 9 /l [6 studies, risk ratio (RR) = 1.215, 95% CI: 1.027-1.436], between PDA and platelet counts <100 × 10 9 /l (5 studies, RR = 1.255, 95% CI: 1.034-1.525), and between significant PDA (SPDA) and platelet counts <100 × 10 9 /l (5 studies, RR = 1.254, 95% CI: 1.021-1.540). The association between SPDA and platelet counts <150 × 10 9 /l was not statistically significant (6 studies, RR = 1.289, 95% CI: 0.925-1.795). Pooled standard differences in mean platelet counts between infants with and without PDA/SPDA were not statistically different. Conclusion: This meta-analysis reveals a marginal but significant association between low platelet counts in the first day(s) of life and PDA/SPDA in very preterm infants. This association needs to be confirmed in prospective studies.