PDF(Pubmed)
Abstract：
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.
摘要：
免疫性血小板减少性紫癜（ITP）占怀孕期间血小板减少症病例的约1％至4％。预测新生儿血小板减少症和母亲ITP相关发病率的因素尚不清楚。本研究旨在评估ITP孕妇的新生儿结局。55名患有ITP的孕妇及其婴儿，在2013年1月至2021年4月之间出生,我们进行了回顾性分析.除ITP外的孕产妇和新生儿血小板减少病例被排除在研究之外。体格检查,血细胞计数,记录新生儿的颅/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。探讨新生儿血小板减少症与母体因素的关系。在17/55的婴儿中发现了血小板减少症（30.9％），8/17（47.1％）有出血症状，除了一个是轻微的出血。新生儿血小板计数<100×109/L与产妇脾切除史存在显著相关性。在ITP母亲的新生儿中，中度和重度血小板减少症的发生率更高（统计学上无统计学意义）。母体和新生儿血小板计数之间没有显着相关性。有或没有血小板减少症的母亲的新生儿的血小板计数之间的相关性较弱。发现母亲分娩前脾切除术的存在与新生儿血小板计数<100×109/L之间存在显着相关性。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，中度和重度血小板减少症较高。但差别不大.对出生后患有ITP的母亲所生的婴儿进行密切随访至关重要，因为没有重要的预测标准来预测新生儿血小板减少症和相关的发病率。
