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KMID : 0366220140490040259
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Korean Journal of Hematology
2014 Volume.49 No. 4 p.259 ~ p.264
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Can we predict neonatal thrombocytopenia in offspring of women with idiopathic thrombocytopenic purpura?
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Hachisuga Kazuhisa
Hidaka Nobuhiro
Fujita Yasuyuki
Fukushima Kotaro
Kato Kiyoko
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Abstract
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Background: We aimed to investigate which factors in the clinical profile of mothers with idiopathic thrombocytopenic purpura (ITP) can predict neonatal risk of thrombocytopenia.
Methods: Data was retrospectively collected from all pregnant women with ITP who presented to our institution between 2001 and 2013. Neonatal offspring of these women were classi-fied 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 throm-bocytopenia 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.
Results: Sixty-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).
Conclusion: Thrombocytopenia in neonates of women with ITP cannot be predicted by maternal treat-ment 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.
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KEYWORD
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Idiopathic thrombocytopenic purpura, Pregnancy, Neonatal thrombocytopenia
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