Risson David C, Davies Mark W, Williams Bronwyn A
Grantley Stable Neonatal Unit, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
J Paediatr Child Health. 2012 Sep;48(9):816-22. doi: 10.1111/j.1440-1754.2012.02528.x.
Neonatal alloimmune thrombocytopenia (NAIT), with an incidence of one in 1000 live births, is the most common cause of severe thrombocytopenia and intra-cerebral haemorrhage in term neonates. NAIT results from trans-placental passage of maternal antibodies against a paternally derived fetal platelet alloantigen. Clinical presentation varies from unexpected thrombocytopenia on a blood film in a well newborn to intracranial haemorrhage (ICH). In contrast to haemolytic disease of the newborn, NAIT can present in a first pregnancy, and subsequent pregnancies are usually more severely affected. The role of antenatal screening for maternal alloantibodies instead of fetal blood sampling to identify at-risk fetuses remains uncertain, but there is a trend towards less invasive maternally directed treatment for at-risk pregnancies. Neonatal management is aimed at preventing or limiting thrombocytopenic bleeding with transfusion of antigen-matched platelets.
新生儿同种免疫性血小板减少症（NAIT）的发病率为千分之一活产儿，是足月儿严重血小板减少症和脑内出血的最常见原因。NAIT是由母体针对父源性胎儿血小板同种抗原的抗体经胎盘传递所致。临床表现差异很大，从健康新生儿血涂片上意外发现血小板减少到颅内出血（ICH）。与新生儿溶血病不同，NAIT可在首次妊娠时出现，且后续妊娠通常受影响更严重。产前筛查母体同种抗体而非进行胎儿血液采样以识别高危胎儿的作用仍不确定，但对于高危妊娠，有采用侵入性较小的母体定向治疗的趋势。新生儿管理旨在通过输注抗原匹配的血小板来预防或限制血小板减少性出血。
