Better recognition and treatment of fetal and neonatal alloimmune thrombocytopenia (FNAIT) have led to far fewer deaths and serious brain bleeds in newborns, according to a medical review published recently in the International Journal of Advance Research, Ideas, and Innovations in Technology.
Doctors can now diagnose FNAIT earlier and use proven therapies to help protect babies before devastating complications occur.
FNAIT, once seen as a disorder with high mortality and lasting disability, is now more often caught in time to make a difference. Still, children may face long-term developmental problems, even if they did not have obvious bleeding in the brain as infants.
The condition happens when a mother’s immune system makes antibodies against platelets that the baby inherited from the father. These antibodies attack the baby’s platelets, which are critical for blood clotting. Unlike maternal immune thrombocytopenia, the mother’s platelet count remains normal. Newborns typically show signs such as pinpoint red or purple spots on the skin within the first two days of life. In severe cases, babies can develop bleeding inside organs or the brain, which can be fatal or lead to permanent impairment.
Read more about testing and diagnosis for FNAIT
Different platelet mismatches create different risks depending on ancestry. In Europe, about three-quarters to nearly all cases come from a mismatch called HPA-1a, with brain bleeding occurring in 10% to 30% of affected infants. In East Asia, HPA-4b is more often the cause. Less common mismatches usually lead to milder disease. These differences highlight why knowing which mismatches are most common in each population matters for screening and prevention.
Doctors diagnose FNAIT using specialized blood tests and genetic typing. The disease should be considered if a healthy newborn has dangerously low platelets while the mother’s blood counts are normal, or if a baby shows unexplained brain bleeding before birth.
Treatment during pregnancy can include intravenous immunoglobulin starting at 12 to 16 weeks, which raises platelet counts in most cases. Steroids or platelet transfusions before birth may also be used when needed. Babies may be delivered by cesarean section to lower the risk of trauma-related bleeding.
After birth, affected infants are often given platelet transfusions from the mother or a matched donor, along with intravenous immunoglobulin, to help recovery. Most babies improve within a few weeks as the mother’s antibodies leave the bloodstream.
Researchers are also studying preventive approaches, including new antibodies that may stop the disease before it starts. In the United States, both the National Institutes of Health and the Centers for Disease Control and Prevention are funding studies to improve testing and treatment, reflecting the growing awareness of this rare but serious condition.
“These efforts reflect a growing recognition that rare diseases like NAIT require both specialized care and broader awareness among general obstetric and neonatal providers,” explained the author of this review.
Sign up here to get the latest news, perspectives, and information about FNAIT sent directly to your inbox. Registration is free and only takes a minute.
