Neonatal Thrombocytopenia as a Consequence of Maternal Preeclampsia

Kalagiri, Ram R.; Choudhury, Saiara; Carder, Timothy; Govande, Vinayak; Beeram, Madhava R.; Uddin, Mohammad Nasir

doi:10.1055/s-0035-1565923

Cited by 27 publications

(25 citation statements)

References 30 publications

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“…[18,19,20] Further, Cluster 3, which had the lowest protein levels of the cohort had higher rates of infants from mothers with pre-eclampsia. Higher cytokine levels have been reported in preeclamptic maternal plasma samples [21], however, maternal pre-eclampsia can result in neonatal thrombocytopenia and platelet production is influenced by cytokines and growth factors [22] which may explain the association between pre-eclampsia and lower cytokine levels found in our infant airway samples. This cluster also tended to be dominated by Staphylococcus, and was markedly lacking in Ureaplasma.…”

Section: Discussionmentioning

confidence: 51%

Prenatal complications are associated with the postnatal airway host response and microbiota in intubated preterm infants

Wagner

Sontag

Harris

et al. 2017

The Journal of Maternal-Fetal & Neonatal Medicine

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Section: Discussionmentioning

confidence: 51%

Prenatal complications are associated with the postnatal airway host response and microbiota in intubated preterm infants

Wagner

Sontag

Harris

et al. 2017

The Journal of Maternal-Fetal & Neonatal Medicine

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“…Hypertensive disorders of pregnancy are associated with platelet dysfunctions in the newborn. Pregnancy-induced hypertension (PIH) is a risk factor for early onset thrombocytopenia in the newborn [77]. This is especially true for babies born prior to 36 weeks of gestation [78,79].…”

Section: Prenatal and Maternal Factors Associated With Neonatal Platementioning

confidence: 99%

Platelets in the Newborn

Esiaba¹,

Mousselli²,

Faison³

et al. 2019

Neonatal Medicine

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Platelets were first described in the mid-nineteenth century. Since then, their roles were identified in hemostasis and thrombosis, inflammation, leukocyte interactions, angiogenesis, and cancer growth. But there is little information about such platelet functions in the newborn. Several studies highlighted some platelet differences between newborns and adults. Yet, in spite of these differences, healthy newborns appear to be adequately protected. A number of factors, however, were reported to negatively affect neonatal platelets. These include maternal hypertensive disorders or infections, neonatal asphyxia or respiratory distress, therapies such as ampicillin or indomethacin, and treatment modalities such as ventilators, nitric oxide, or extracorporeal membrane oxygenation (ECMO). Their effects on newborn platelets are usually transitory, lasting from several hours to a few days or weeks. If these effects are well characterized, they could serve as reporters for diagnosis and monitoring during therapy. Careful studies of neonatal platelets are needed to improve the understanding of basic physiology and pathophysiology in this cohort and to identify possible targets for intervention and therapy.

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“…74,76 The pathophysiology of this thrombocytopenia remains debated. 78 Fetal hypoxia due to placental hypoperfusion may suppress the proliferation of MKs, thus resulting in reduction of platelet production in favor of erythropoiesis, 73,76 while the consumption of platelets on a thrombotic bed of placenta could provide another explanation. 73,79 On the other hand, Zook et al failed to connect neonatal thrombocytopenia to placental histopathology.…”

Section: Hypertensive Disorders Of Pregnancymentioning

confidence: 99%

High-Risk Pregnancies and Their Impact on Neonatal Primary Hemostasis

Politou

Mougiou

Kollia

et al. 2019

Semin Thromb Hemost

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Primary hemostasis, similar to other systems in the adjusting and transitioning neonate, undergoes developmental adaptations in the first days of life. Although platelets of neonates do not differ quantitatively compared with those of adults, they functionally present with major differences, thus supporting the theory of a “hypofunctional” phenotype that is counterbalanced by high hematocrit and more potent von Willebrand factor multimers. No clinical effect of bleeding tendency has hence been established so far for healthy term neonates. However, discrepancies in functionality have been noted, associated with gestational age, with more pronounced platelet hyporesponsiveness in preterm neonates. Multiple methods of in vitro platelet function evaluation such as PFA-100/200, platelet aggregometry, flow cytometry, and cone and platelet analyzer have been used for assessment of neonatal primary hemostasis. Several pregnancies are characterized as “high-risk” when risk factors preexist in maternal history or evolve during pregnancy. These pregnancies require specialized observation as they may have unpredictable outcome. High-risk pregnancies include clinical entities such as preeclampsia, pregnancy-induced smoking during pregnancy, gestational diabetes mellitus (GDM), autoimmune diseases, and other maternal hematological conditions. In some cases, like systemic lupus erythematosus, antiphospholipid antibody syndrome, and maternal immunologically based thrombocytopenia, neonatal thrombocytopenia is regarded as a prominent hemostasis defect, while in others, like pregnancy-induced hypertension and preeclampsia, both quantitative and qualitative disorders of neonatal platelets have been reported. In other pathologies, like GDM, neonatal primary hemostasis remains vastly unexplored, which raises the need for further investigation. The extent to which primary hemostasis is affected in neonates of high-risk pregnancies is the main objective of this narrative review.

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Neonatal Thrombocytopenia as a Consequence of Maternal Preeclampsia

Cited by 27 publications

References 30 publications

Prenatal complications are associated with the postnatal airway host response and microbiota in intubated preterm infants

Prenatal complications are associated with the postnatal airway host response and microbiota in intubated preterm infants

Platelets in the Newborn

High-Risk Pregnancies and Their Impact on Neonatal Primary Hemostasis

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