The prenatal prediction of thrombocytopenia in infants of mothers with clinically diagnosed immune thrombocytopenia

Kelton, John G.; Inwood, Martin J.; Barr, Robert M.; Effer, Sidney B.; Hunter, David J.; Wilson, William E.; Ginsburg, David A.; Powers, Peter

doi:10.1016/0002-9378(82)90252-6

Cited by 80 publications

(21 citation statements)

References 13 publications

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“…We were also in good agreement with previous authors in finding no correlation between maternal concentration of PAIgG and fetal platelet counts [2,5], although a single study found good correlation between these variables [4].…”

Section: Discussionsupporting

confidence: 93%

Risk factors for neonatal thrombocytopenia in pregnancy complicated by idiopathic thrombocytopenic purpura

Yamada

Kato

Kishida

et al. 1998

Annals of Hematology

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The aim of this study was to evaluate risk factors for the occurrence of fetal/neonatal passive immune thrombocytopenia (PIT) in pregnancy complicated with ITP. We studied 52 pregnancies with ITP and the 54 neonates retrospectively. Neonatal platelet counts were compared with maternal platelet counts, platelet-associated IgG (PAIgG) values and the presence of antiplatelet antibody in maternal circulation, history of previous PIT, maternal treatments for ITP, and other maternal/neonatal factors including gestational age and birth weight. Logistic regression analysis for multivariables was performed. PIT (platelet counts < 100 x 10(3)/microl) without neonatal mortality or any morbidity was observed in eight (15.4%) of 52 pregnancies. The presence of circulating antiplatelet antibodies in maternal blood, splenectomy prior to pregnancy, and a history of previous PIT were observed more frequently with statistical significance in women giving birth to neonates who developed PIT. By logistic regression analysis, splenectomy prior to pregnancy was found to be the single significant variable (p=0.017, odds ratio 9.33) among the risk factors for PIT. Thus, splenectomy prior to pregnancy is related to increased risk for PIT in ITP-complicated pregnancy.

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Section: Discussionsupporting

confidence: 93%

Risk factors for neonatal thrombocytopenia in pregnancy complicated by idiopathic thrombocytopenic purpura

Yamada

Kato

Kishida

et al. 1998

Annals of Hematology

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“…Moreover, to date there is no readily available noninvasive test to identify thrombocytopenic fetuses. There is a poor correlation between maternal and neonatal platelet counts and between maternal antiplatelet IgG titers and fetal platelet counts [6,7]. PUBS is helpful in the determination of fetal platelets [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Some authors have reported that either platelet-attached (direct) [6] or circulating (indirect) antiplatelet antibodies [12] correlate well with neonatal thrombocytopenia. However, others failed to demonstrate any consistent correlation with either the platelet-attached [12] or circulating antibodies [5].…”

Section: Discussionmentioning

confidence: 99%

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

Song

Lee²,

Kim³

et al. 1999

Fetal Diagn Ther

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Objective: To estimate the risk of neonatal thrombocytopenia in infants born to mothers with immune thrombocytopenic purpura (ITP). Methods: During the years 1993–1997, there were 6,082 deliveries. There were 32 infants born to 31 mothers with ITP. Cordocentesis was performed between 34 and 41 weeks of gestation in 16 mothers with ITP. The cord blood platelet count was checked in all cases at delivery. Results: In mothers with ITP, 5 neonates (15.6%) had mild thrombocytopenia and 7 neonates (21.9%) moderate thrombocytopenia. Severe thrombocytopenia was not observed in any neonate born to mothers with ITP. Conclusions: The means of delivery in pregnant women with ITP can be determined solely on the basis of obstetric indications because the incidence of severe fetal and neonatal thrombocytopenia is very rare, neonatal intracranial hemorrhage is unlikely to be related to the mode of delivery and percutaneous umbilical blood sampling is technically difficult with a risk of fetal death.

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“…The necessarily unsatisfactory nature of this policy stems largely from our inability to diagnose PAT with certainty, and from the fact that the fetal platelet count correlates very poorly with that of the mother in cases of maternal AITP [17,18]. Improving our knowledge in these important areas would allow a more rational approach to the management of the thrombocytopenic woman in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy-Associated Thrombocytopenia: Definition, Incidence and Natural History

Matthews¹,

Benjamin²,

Gill³

et al. 1990

Acta Haematol

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We have sought to clarify the definition and importance of newly diagnosed thrombocytopenia in pregnant women by establishing an appropriate reference interval for the platelet count, and by observing the outcome in a cohort of thrombocytopenic pregnant women. The mean platelet count was lower in 2,155 healthy pregnant than non-pregnant women, and varied with race, but did not fall with increasing gestation, except in Black women. 101 of approximately 2,800 women became newly thrombocytopenic during pregnancy by conventional criteria (platelets < 150 × 10⁹/l), without an apparent cause. Using the reference intervals established during the study, however, 24 of these women would not have been regarded as thrombocytopenic. No bleeding tendency was observed in the mothers or their infants. Maternal platelet counts became normal in the postnatal period. Thrombocytopenia occurring for the first time during pregnancy may be a different condition from auto-immune thrombocytopenia, and we suggest the term ‘pregnancy-associated thrombocytopenia’ (PAT). PAT does not appear to be epidemic; it does not threaten the fetus, but it cannot be distinguished from auto-immune thrombocytopenia in individual cases.

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The prenatal prediction of thrombocytopenia in infants of mothers with clinically diagnosed immune thrombocytopenia

Cited by 80 publications

References 13 publications

Risk factors for neonatal thrombocytopenia in pregnancy complicated by idiopathic thrombocytopenic purpura

Risk factors for neonatal thrombocytopenia in pregnancy complicated by idiopathic thrombocytopenic purpura

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

Pregnancy-Associated Thrombocytopenia: Definition, Incidence and Natural History

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