Impaired Platelet Recovery Is Associated with Mortality after Severe Neonatal Intraventricular Hemorrhage Brief Report

<title>Abstract</title> <p>Purpose To determine whether longitudinal platelet recovery differs by survival status after severe neonatal intraventricular hemorrhage (IVH). Methods We performed a retrospective secondary analysis of a single-center cohort of 43 infants with grade 3–4 IVH who underwent serial surveillance for post-hemorrhagic ventricular dilatation. The longitudinal subset included infants with at least three numeric platelet measurements and known survival status. Observation-level linear regression was used to display raw platelet trajectories. A linear mixed-effects model with a random intercept for infant, and fixed effects for day of life, survival status, platelet transfusion timing, and their interactions, was used for primary inference. Results Sixteen infants died before hospital discharge. The longitudinal subset comprised 17 infants (12 survivors and 5 non-survivors) and 403 platelet measurements. In the unadjusted model, platelet counts increased in survivors (+ 3.47 × 10⁹/L/day) and decreased in non-survivors (− 1.34 × 10⁹/L/day; interaction p &lt; 2 × 10⁻¹⁶). In the mixed-effects model, survivors showed greater platelet recovery than non-survivors (time-by-death interaction − 1.46 × 10⁹/L/day, 95% CI − 2.48 to − 0.44; p = 0.005). Conclusion Failure of platelet recovery was associated with mortality after severe neonatal IVH. Platelet trajectory may provide prognostic information beyond a single platelet count, but prospective validation and adjustment for illness severity are required.</p>