Alterations in Platelet-to-Lymphocyte Ratio, and Some White Blood Cell Indices in Neonatal Thrombocytopenia

Abstract

Platelets, Neutrophils, Lymphocytes, Neutrophil-to-Lymphocyte ratio (NLR) and Platelet‑to‑Lymphocyte ratio (PLR) have been studied as haematological and biologic markers of infections and inflammation; however, changes in PLT, NLR and some white blood cell indices in neonatal thrombocytopenia in Nigeria have not been sufficiently evaluated. This study therefore aims to compare these haematological and biologic markers among thrombocytopenic and non-thrombocytopenic new-borns at delivery. A total of 374 new-borns comprising of 35 new-borns with thrombocytopenia and 339 non-thrombocytopenic new-borns were recruited for this study and cord blood was collected from them immediately after delivery. Complete blood count was determined on the cord blood using Sysmex KX-21N auto-haematology analyser while platelet-lymphocyte ratio (PLR) and neutrophil-lymphocyte ratio (NLR) were calculated as ratios of their absolute values respectively. Total white blood cell count (15.11 ± 5.38 vs 13.10±5.14 ×10 9 /L) (p<0.0289)
and mean platelet volume (10.63 ± 1.11 vs 9.95±1.14 fL) (p<0.0008) were significantly higher while mean platelet count (113.97±32.84 vs 264.14±71.51) and platelet–to-lymphocyte ratio (28.52±18.64 vs 70.86±38.87) were significantly lower (p<0.0001) among thrombocytopenic new-borns than non-thrombocytopenic counterparts. There was no significant difference in NLR (p > 0.05) between thrombocytopenic and non-thrombocytopenic neonates at birth. The significantly higher leucocyte counts and mean platelet volume among the thrombocytopenic new-borns may suggest sub-clinical and early on-going infectious process, and platelet destruction may be the possible mechanism for the thrombocytopenia.