Neonatal platelet counts in fetal brain injury

The objective of this study was to determine whether neonatal platelet counts can be used in fetal brain injury. The initial platelet counts, expressed as 1000 per mm(3), of singleton term infants with and without permanent asphyxial brain injury were compared. Neonates with encephalopathy were divided into 3 groups: I-nonreactive fetal heart rate (FHR) pattern from admission until delivery; II-reactive FHR pattern on admission followed by nonreactivity, tachycardia, a loss of variability and repetitive FHR decelerations; and III-acute: reactive FHR pattern followed by a sudden prolonged FHR deceleration that lasted until delivery. The neonates and platelet counts for each group were as follows: Control: 104 neonates, mean 281 +/- 56, range 154 to 411; I: 60, mean 185 +/- 80, range 28 to 365; II: 34, mean 251 +/- 66, range 100 to 375; and III: 35, mean 267 +/- 93, range 86 to 569. Platelet counts were significantly lower in neonates with encephalopathy (p <0.001). Group I differed statistically from both Groups II and III (p <0.001). These data suggest an association between the FHR pattern, fetal asphyxial brain injury, and the initial platelet count in singleton term neonates. Further investigation should be pursued to clarify the physiological processes leading to this result.