Deaver J E, Leppert P C, Zaroulis C G
Am J Perinatol. 1986 Apr;3(2):127-31. doi: 10.1055/s-2007-999848.
We reviewed 58 literature reports of neonatal alloimmune thrombocytopenic purpura (NAITP). The mortality rate was 9%. The total incidence of suspected intracranial hemorrhage was 28%. We reviewed 17 sibship cases for the relation of birth order to treatment and outcome. Among firstborn affected infants (n = 17) the mortality rate and incidence of central nervous system sequelae were 24 and 47%, respectively, compared to rates of 5 and 15%, respectively, in their younger affected siblings (n = 20). The improved outcome in the latter group appeared to be related to more frequent cesarean section delivery and more frequent and earlier use of corticosteroids and maternal platelet transfusions in the neonate. Sensitive assays of maternal platelet alloantibody are now available, but they lack specificity for NAITP affecting the current gestation. There are two reports in which sensitive assays revealed rising titers of maternal platelet alloantibody during advancing gestation. We propose further study to determine if this is specific for the antepartum diagnosis of NAITP.
我们回顾了58篇关于新生儿同种免疫性血小板减少性紫癜（NAITP）的文献报告。死亡率为9%。疑似颅内出血的总发生率为28%。我们回顾了17个同胞病例，以研究出生顺序与治疗及预后的关系。在受影响的头胎婴儿（n = 17）中，死亡率和中枢神经系统后遗症的发生率分别为24%和47%，而在其受影响的弟弟妹妹（n = 20）中，这两个比率分别为5%和15%。后一组预后的改善似乎与剖宫产分娩更频繁、新生儿使用皮质类固醇和母体血小板输注更频繁且更早有关。目前已有母体血小板同种抗体的敏感检测方法，但它们对影响当前妊娠的NAITP缺乏特异性。有两份报告显示，敏感检测方法揭示了妊娠进展过程中母体血小板同种抗体滴度升高。我们建议进一步研究以确定这是否对NAITP的产前诊断具有特异性。
