Division of Neonatology, Department of Pediatrics, Uludag University School of Medicine, Bursa, Turkey.
J Perinatol. 2010 Jan;30(1):38-44. doi: 10.1038/jp.2009.134. Epub 2009 Sep 24.
The aim of this study was to determine the factors associated with the prognosis of newborns born to mothers with idiopathic thrombocytopenic purpura (ITP), and to compare the infants with/without thrombocytopenia in terms of maternal and neonatal characteristics.
We reviewed the charts of 29 parturients with ITP and their newborns who were born between January 1998 and December 2008.
A total of 16 (55%) gravidas had been diagnosed with ITP before pregnancy and 13 (45%) were diagnosed during pregnancy. Thrombocytopenia was observed in 21 gravidas. In total, 17 (58%) gravidas received treatment to increase the platelet count. The majority of deliveries (72.5%) were vaginal. The infant platelet counts at birth ranged from 20 to 336 x 10(9) per liter. None of the neonates had complications attributable to the mode of delivery. Normal platelet counts were determined in 15 newborns, whereas 14 infants had thrombocytopenia at birth. Three (10.3%) neonates had mild, four neonates (13.7%) had moderate and seven neonates (24.1%) had severe thrombocytopenia. The age of the mothers having infants with thrombocytopenia was significantly higher (30+/-5.3 vs 25.3+/-3.8 years), most of the infants (10/14 (71%)) were males (P<0.05).
Pregnancy complicated with ITP generally has a good outcome. Although ITP in pregnancy carries a low risk, careful observation is required for the newborn of gravidas with ITP even when the infant has no bleeding complications at delivery, and infants may require treatment for thrombocytopenia.
本研究旨在确定特发性血小板减少性紫癜(ITP)产妇所分娩新生儿的预后相关因素,并比较有无血小板减少症的母婴特征。
我们回顾了 1998 年 1 月至 2008 年 12 月期间 29 名 ITP 产妇及其新生儿的病历。
共有 16 名(55%)孕妇在妊娠前被诊断为 ITP,13 名(45%)在妊娠期间被诊断为 ITP。21 名孕妇出现血小板减少症。共有 17 名(58%)孕妇接受治疗以增加血小板计数。大多数分娩(72.5%)为阴道分娩。新生儿出生时血小板计数范围为 20 至 336×10(9)/升。没有新生儿因分娩方式而出现并发症。15 名新生儿血小板计数正常,而 14 名新生儿出生时血小板减少症。3 名(10.3%)新生儿为轻度,4 名新生儿(13.7%)为中度,7 名新生儿(24.1%)为重度血小板减少症。血小板减少症患儿的母亲年龄明显较高(30+/-5.3 岁比 25.3+/-3.8 岁),大多数患儿(10/14(71%))为男性(P<0.05)。
妊娠合并 ITP 一般预后良好。尽管妊娠 ITP 风险较低,但即使新生儿在分娩时没有出血并发症,也需要对 ITP 孕妇的新生儿进行密切观察,且婴儿可能需要治疗血小板减少症。