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This risk is especially critical in preterm infants or those with other coexisting conditions. While neonatal thrombocytopenia has been studied in some countries, there is limited data and understanding about its prevalence, and associated factors in resource-limited countries especially in Ethiopia. So this study aimed to assess the prevalence and factors associated with thrombocytopenia among neonates admitted to the neonatal intensive care unit of Northwest Amhara Region Comprehensive Specialized Hospitals in Northwest Ethiopia, 2022. Institution-based cross-sectional study design was conducted from October 05 to November 03, 2022, and a systematic random sampling technique was used to select 423 study participants. Data were collected by interviewing mothers and reviewing neonates\u2019 medical records. Data were entered into Epi-Data version 4.6.0 and exported to STATA version 14 for analysis. Both bivariable and multivariable logistic regression models were used for analysis. P-value of less than 0.05 and odds ratio with 95% CI was used to declare the presence of association. A total of 415 neonate-mother pairs were involved with a response rate of 98.1%. The prevalence of thrombocytopenia among neonates admitted to the neonatal intensive care unit Is found to be 26.02%; [95% CI (22.01\u201330.48%)]. In the multivariable analysis severe pre-eclampsia (AOR\u2009=\u20092.84 95% CI 1.29\u20136.27), prolonged rupture of membrane (AOR\u2009=\u20092.85 95% CI 1.21\u20136.72), neonatal sepsis (AOR\u2009=\u20096.50 95% CI 3.58\u201311.79), perinatal asphyxia (AOR\u2009=\u20094.15 95% CI 1.97\u20138.76), and necrotizing enterocolitis (AOR\u2009=\u20093.71 95% CI 1.68\u20138.19) were significant factors to thrombocytopenia. To decrease the occurrence of neonatal thrombocytopenia better to give special attention and priority to neonates diagnosed with sepsis, perinatal asphyxia, necrotizing enterocolitis, and mothers who had prolonged rupture of membrane or severe pre-eclampsia.<\/jats:p>","DOI":"10.1038\/s41598-025-93042-0","type":"journal-article","created":{"date-parts":[[2025,4,12]],"date-time":"2025-04-12T09:28:17Z","timestamp":1744450097000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence and associated factors of thrombocytopenia among neonates in Northwest Amhara region comprehensive specialized hospitals, Ethiopia: a cross sectional study"],"prefix":"10.1038","volume":"15","author":[{"given":"Asnake Tadesse","family":"Abate","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gezahagn Demsu","family":"Gedefaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanyalew Worku","family":"Kassahun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengistu Mekonnen","family":"Kelkay","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,12]]},"reference":[{"issue":"2","key":"93042_CR1","doi-asserted-by":"publisher","first-page":"115","DOI":"10.5457\/p2005-114.117","volume":"11","author":"J Roganovi\u0107","year":"2015","unstructured":"Roganovi\u0107, J. et al. 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