Low Neonatal Risk of Thrombocytopenia in Pregnancy Associated with Immune Thrombocytopenic Purpura

Song, Tae Bok; Lee, Ji-Young; Kim, Yoon-Ha; Kim, Choong-Young

doi:10.1159/000020924

Cited by 14 publications

(6 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Severe thrombocytopenia in the newborn can cause hemorrhagic manifestations, the most dangerous of which is intracranial hemorrhage. In our cohort, thrombocytopenia was observed in 19.7% of neonates, which is similar to rates previously described [ 4 , 5 , 6 , 7 , 8 ]. Although its incidence is relatively low, intracranial bleeding is a serious thrombocytopenia complication in neonates born to mothers with ITP [ 4 , 5 , 9 , 10 ].…”

Section: Discussionsupporting

confidence: 91%

Can we predict neonatal thrombocytopenia in offspring of women with idiopathic thrombocytopenic purpura?

et al. 2014

View full text Add to dashboard Cite

BackgroundWe aimed to investigate which factors in the clinical profile of mothers with idiopathic thrombocytopenic purpura (ITP) can predict neonatal risk of thrombocytopenia.MethodsData was retrospectively collected from all pregnant women with ITP who presented to our institution between 2001 and 2013. Neonatal offspring of these women were classified into 2 groups based on the presence or absence of neonatal thrombocytopenia (platelet count <100×109/L). Several parameters were compared between the 2 groups, including maternal age, maternal platelet count, maternal treatment history, and thrombocytopenia in siblings. We further examined the correlation between maternal platelet count at the time of delivery and neonatal platelet count at birth; we also examined the correlation between the minimum platelet counts of other children born to multiparous women.ResultsSixty-six neonates from 49 mothers were enrolled in the study. Thrombocytopenia was observed in 13 (19.7%) neonates. Maternal treatment for ITP such as splenectomy did not correlate with a risk of neonatal thrombocytopenia. Sibling thrombocytopenia was more frequently observed in neonates with thrombocytopenia than in those without (7/13 vs. 4/53, P<0.01). No association was observed between maternal and neonatal platelet counts. However, the nadir neonatal platelet counts of first- and second-born siblings were highly correlated (r=0.87).ConclusionThrombocytopenia in neonates of women with ITP cannot be predicted by maternal treatment history or platelet count. However, the presence of an older sibling with neonatal thrombocytopenia is a reliable risk factor for neonatal thrombocytopenia in subsequent pregnancies.

show abstract

Section: Discussionsupporting

confidence: 91%

Can we predict neonatal thrombocytopenia in offspring of women with idiopathic thrombocytopenic purpura?

et al. 2014

View full text Add to dashboard Cite

show abstract

“…In our series, only two of the offspring of the five mothers with chronic ITP suffered TP, an incidence of 40% which is in concordance with other reports [14][15][16]. It was also observed that of the two neonates who suffered in relation to maternal ITP, only one was associated with TP in the mother.…”

Section: Discussionsupporting

confidence: 92%

Neonatal Immune Thrombocytopenia

Raju

Arora

2004

Medical Journal Armed Forces India

View full text Add to dashboard Cite

Background : Neonatal immune thrombocytopenia, a consequence of transplacental transfer of antiplatelet antibodies can result in serious bleeding with disastrous consequences in the otherwise healthy newborn. Methods : Over 2 years at a service hospital, 5 mothers with chronic autoimmune thrombocytopenia and one with maternal alloimmunisation delivered, which comprised the study sample. Results : Of these, two ladies suffered episodes of thrombocytopenia in the current pregnancy. They were provided platelet transfusions and intravenous immunoglobulins. All patients delivered vaginally. Cord blood platelet was normal in all cases. Three babies developed thrombocytopenia, two due to autoimmune and one alloimmune pathology. The nadir of thrombocytopenia occurred in 36-72 hours with recovery taking place in 10 days. The clinical manifestations were petechiae, ecchymosis, gastric bleed and oozing from vitamin K injection site. Two of the affected babies were provided intravenous immunoglobulins and one steroids. Only one of the two mothers who suffered thrombocytopenia during pregnancy and was provided intravenous immunoglobulins was associated with neonatal thrombocytopenia, an inconsistent relation. It was also observed that antenatally provided immunoglobulins raised effectively maternal rather than fetal platelet counts. However, postnatal immunoglobulins were efficacious in thrombocytopenic neonates. Conclusion : Thus inspite of several therapeutic and preventive modalities being described, the optimum management strategy of immune mediated perinatal thrombocytopenia is yet in evolution.

show abstract

“…Despite low maternal platelet count, fetal intracranial haemorrhage is very rare. Hence, the mode of delivery in these patients can be determined mainly by obstetric indications (Song et al 1999;Payne et al 1997).…”

Section: Discussionmentioning

confidence: 99%