Department of Pediatrics, Division of Neonatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye.
Department of Obstetrics and Gynecology, Division of Perinatology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Türkiye.
Medicine (Baltimore). 2024 Jun 21;103(25):e38587. doi: 10.1097/MD.0000000000038587.
Immune thrombocytopenic purpura (ITP) comprises ~1% to 4% of thrombocytopenia cases during pregnancy. Factors predicting neonatal thrombocytopenia and associated morbidities due to maternal ITP are unclear. The present study aimed to assess the neonatal outcomes of pregnant women with ITP. Fifty-five pregnant women with ITP and their babies, born between January/2013 and April/2021, were retrospectively reviewed. Maternal and neonatal thrombocytopenia cases other than ITP were excluded from the study. Physical examination, blood count, and cranial/abdominal ultrasonography findings of the newborns were recorded. Neonatal thrombocytopenia was defined as a platelet count < 150 × 109/L. Relationship between neonatal thrombocytopenia and maternal factors was investigated. Thrombocytopenia was detected in 17/55 babies (30.9%), and 8/17 (47.1%) had symptoms of bleeding, all but one being mild bleeding. There was a significant correlation between neonatal platelet counts of < 100 × 109/L and maternal splenectomy history. Incidence of moderate and severe thrombocytopenia was higher (statistically insignificant) in neonates of mothers with ITP. No significant correlation was determined between maternal and neonatal platelet counts. There was a weak insignificant correlation between platelet counts of neonates of mothers with or without thrombocytopenia. A significant correlation was found between the presence of splenectomy before delivery in the mother and a platelet count of < 100 × 109/L in the neonate. Moderate and severe thrombocytopenia was higher in neonates of mothers diagnosed with ITP before pregnancy and needed treatment during pregnancy and/or delivery, but the difference was insignificant. Close follow-up of babies born to mothers with ITP after birth is crucial since there is no significant prediction criterion for developing neonatal thrombocytopenia and associated morbidities.
免疫性血小板减少性紫癜（ITP）占妊娠期血小板减少症的 1%至 4%。目前尚不清楚预测母体 ITP 导致新生儿血小板减少症和相关并发症的因素。本研究旨在评估 ITP 孕妇的新生儿结局。回顾性分析了 2013 年 1 月至 2021 年 4 月期间 55 例 ITP 孕妇及其婴儿的资料。排除了除 ITP 以外的母体和新生儿血小板减少症病例。记录新生儿的体格检查、血常规和头颅/腹部超声检查结果。新生儿血小板减少症定义为血小板计数＜150×109/L。研究了新生儿血小板减少症与母体因素的关系。17/55 例婴儿（30.9%）存在血小板减少症，其中 8/17 例（47.1%）有出血症状，除 1 例外均为轻度出血。新生儿血小板计数＜100×109/L 与母亲脾切除术史有显著相关性。中重度血小板减少症在 ITP 母亲的新生儿中发生率更高（统计学上无显著性差异）。母亲和新生儿血小板计数之间无显著相关性。母亲有或无血小板减少症的新生儿血小板计数之间存在微弱的无显著性相关性。母亲在分娩前有脾切除术与新生儿血小板计数＜100×109/L 之间存在显著相关性。在妊娠前诊断为 ITP 且在妊娠和/或分娩期间需要治疗的母亲的新生儿中，中重度血小板减少症发生率更高，但差异无统计学意义。对患有 ITP 的母亲所生婴儿出生后进行密切随访非常重要，因为目前尚无新生儿血小板减少症及其相关并发症发生的显著预测标准。
