A study recently published in Transfusion and Apheresis Science showed that early genetic testing, combined with clinical history assessment, may improve the prediction of fetal and neonatal alloimmune thrombocytopenia (FNAIT) severity.
By identifying high-risk patients early, healthcare providers can guide individualized care to ensure healthy newborns without serious complications.
Platelets are essential for blood clotting, and, depending on disease severity, reduced platelet number can be without symptoms, or it can lead to bleeding, such as skin bleeding or blood in urine. Their destruction can lead to a life-threatening intracranial hemorrhage (ICH), dangerous bleeding in the brain that can cause permanent disability or death.
The study found that the maternal HLA-DRB3*01:01 allele is a useful predictor of FNAIT severity. Specifically, women who carry this genetic marker and have a history of baby with ICH in a previous pregnancy are classified in the high-risk category.
Learn more about FNAIT testing and diagnosis
In this study, researchers reported on cases of three women who were HLA-DRB3*01:01 positive and had a history of FNAIT-affected newborns in previous pregnancies. To manage the risk, all three patients received a combination of weekly intravenous immunoglobulin (IVIG), which helps prevent the mother’s antibodies from attacking fetal platelets, and corticosteroids. This therapy was initiated between the 14th and 20th weeks of gestation.
Despite the high-risk nature of these pregnancies, the proactive and personalized treatment approach led to successful outcomes. All three women gave birth to healthy newborns with no signs of intracranial hemorrhage or long-term complications, regardless of whether they started treatment earlier or later.
These results underscore the importance of integrating genetic profiling with medical history to stratify risk and provide a clear clinical pathway for protecting both the mother and the child.
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