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Effect of delivery mode on postnatal platelet count dynamics in neonates born to mothers with immune thrombocytopenia

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Abstract

We aimed to determine the effect of delivery mode on postnatal platelet count dynamics in neonates born to mothers with immune thrombocytopenia (ITP). This single-center, retrospective study included 41 mothers with ITP and their 65 infants born by vaginal delivery (VD, n = 30) and cesarean section (CS, n = 35) between January 1997 and March 2022. The median difference in platelet counts from day 0 to day 2 (ΔPlt [D 0–2]) was significantly lower in the VD group (− 39 × 109/L, interquartile range [IQR]: − 47 to − 24 × 109/L) than the CS group (15 × 109/L, IQR: − 6.5 to 33 × 109/L) (p < 0.001). The median ΔPlt (D 0–5) was significantly lower in the VD group (− 55 × 109/L, IQR: − 85 to − 31 × 109/L) than the CS group (33 × 109/L, IQR: 1–69 × 109/L) (p < 0.001). Multivariate analysis also showed a significant association of delivery mode with ΔPlt (D 0–2) and ΔPlt (D 0–5) (both p < 0.001). VD neonates with platelet counts ≥ 100 × 109/L at birth were significantly more likely than CS neonates to develop thrombocytopenia < 100 × 109/L at nadir (1/26 vs. 6/25) (p = 0.0496). Our findings indicate that mode of delivery is a useful predictor of postnatal platelet count dynamics in neonates born to mothers with ITP.

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Data availability

SW and KM had full access to the data in the study and take responsibility for the accuracy and integrity of the data. Data are available upon reasonable request.

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Acknowledgements

We wish to thank all patients and their parents, whose contribution made this study possible.

Funding

The study was performed with no funding.

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Authors and Affiliations

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

    Shoichiro Wada, Kousaku Matsubara, Aya Iwata, Kenichi Isome, Masayuki Hori, Yu Kawasaki, Akiyoshi Naito, Kaya Kim, Kyohei Iio & Yoshimichi Yamaguchi

  2. Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan

    Chisato Miyakoshi

Authors
  1. Shoichiro Wada
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  11. Yoshimichi Yamaguchi
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Contributions

KM designed the study, collected data, carried out the analyses, drafted the paper, and revised the paper. SW collected data, carried out the analyses, drafted the paper, and revised the paper. CM carried out statistical analyses and critically revised the manuscript. AI, KeI, MH, YK, AN, KK, KyI, and YY critically reviewed the paper for important intellectual content. All authors read and approved the final manuscript as submitted.

Corresponding author

Correspondence to Kousaku Matsubara.

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Conflict of interest

The authors declare no competing interests.

Ethical approval

The design and execution of this study complied with the ethical standards of the Declaration of Helsinki. The study was approved by the Ethics Committee of Kobe City Nishi-Kobe Medical Center, Kobe (approval number: 2022-06). Written informed consent was not obtained from participants; instead, an opt-out was indicated on the website of our institute. Those who refused were excluded.

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Wada, S., Matsubara, K., Miyakoshi, C. et al. Effect of delivery mode on postnatal platelet count dynamics in neonates born to mothers with immune thrombocytopenia. Int J Hematol 118, 18–25 (2023). https://doi.org/10.1007/s12185-023-03582-2

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  • DOI: https://doi.org/10.1007/s12185-023-03582-2

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