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Factors predictive of neonatal thrombocytopenia in pregnant women with immune thrombocytopenia

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Abstract

To determine predictive factors for neonatal thrombocytopenia in deliveries with immune thrombocytopenia (ITP), we conducted a retrospective study at a tertiary hospital between 1997 and 2013. During this period, 30 women with ITP delivered 44 children. Neonatal thrombocytopenia (<100 × 109/L) at birth was observed in seven neonates; four of these cases were severe (<50 × 109/L). No cases were complicated by intracranial hemorrhage, and there was no neonatal mortality. Platelet counts at birth of neonates born to mothers, who had first been diagnosed with ITP during pregnancy were significantly higher than those born to mothers diagnosed with ITP before pregnancy. There were significant correlations between neonatal platelet counts in the first and second siblings at birth (P = 0.015) and at nadir (P = 0.035). Platelet counts of neonates born vaginally were significantly more likely to decline after birth than those delivered by cesarean section (13/16 vs. 10/23, P = 0.024). In conclusion, diagnosis of ITP before pregnancy was significantly associated with neonatal thrombocytopenia, and the platelet count of an older sibling is a strong predictor for that of the next baby. The delivery mode may be an indicator of the timing of platelet count nadir after birth.

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Abbreviations

CBC:

Complete blood count

emCS:

Emergency cesarean section

ITP:

Immune thrombocytopenia

IVIG:

Intravenous immunoglobulin

mPSL:

Methylprednisolone

plCS:

Planned cesarean section

PSL:

Prednisolone

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Acknowledgment

This work was supported by a research grant from the Japanese Ministry of Health, Labour and Welfare.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Pediatrics, Nishi-Kobe Medical Center, 5-7-1 Kojidai, Nishi-ku, Kobe, 651-2273, Japan

    Koji Kawaguchi, Kousaku Matsubara, Aya Iwata, Hiroyuki Nigami & Takashi Fukaya

  2. Department of Hematology and Clinical Immunology, Nishi-Kobe Medical Center, Kobe, Japan

    Toshiro Takafuta, Isaku Shinzato & Yasuhiro Tanaka

  3. Department of Obstetrics and Gynecology, Nishi-Kobe Medical Center, Kobe, Japan

    Yasuhito Takeuchi

Authors
  1. Koji Kawaguchi
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  2. Kousaku Matsubara
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  3. Toshiro Takafuta
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  4. Isaku Shinzato
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  5. Yasuhiro Tanaka
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  6. Aya Iwata
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  7. Hiroyuki Nigami
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  8. Yasuhito Takeuchi
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  9. Takashi Fukaya
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Corresponding author

Correspondence to Koji Kawaguchi.

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Kawaguchi, K., Matsubara, K., Takafuta, T. et al. Factors predictive of neonatal thrombocytopenia in pregnant women with immune thrombocytopenia. Int J Hematol 99, 570–576 (2014). https://doi.org/10.1007/s12185-014-1562-6

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  • DOI: https://doi.org/10.1007/s12185-014-1562-6

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