A recently published study found that among women with immune thrombocytopeniaThrombocytopenia A platelet count that is lower than normal. (ITP), disease worsening during pregnancy was relatively common, while neonatal thrombocytopeniaNeonatal thrombocytopenia Low platelet count in a newborn. In FNAIT, platelet levels may drop dangerously low within hours after birth. affected a minority of newborns.
ITP is a condition that can complicate pregnancy by lowering platelet counts and increasing bleeding risk. The research, presented at the 2026 Congress of the European Hematology Association, included data on maternal and neonatal outcomes spanning 20 years
Researchers conducted a retrospective analysis of 69 patients with primary ITP who experienced 111 pregnancies, resulting in 107 newborns including 101 live births, between 2005 and 2025. The study examined disease progression during pregnancy, treatment patterns, delivery methods and maternal and neonatal outcomes.
The average age at ITP diagnosis was 25 years, while the average age during pregnancy was 30 years.
Overall, worsening thrombocytopenia occurred in 40 pregnancies, representing 36% of the study participants. Half of these episodes developed during the first trimester. Twenty-seven pregnancies (24%) required ITP-specific treatment, most commonly corticosteroids. Two patients received intravenous immunoglobulinIntravenous immunoglobulin A treatment given to pregnant women with a history of FNAIT or known alloantibodies. IVIG reduces the immune reaction against fetal platelets. (IVIGIntravenous immunoglobulin A treatment given to pregnant women with a history of FNAIT or known alloantibodies. IVIG reduces the immune reaction against fetal platelets.).
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To prepare for delivery, hematologic interventions, such as corticosteroid boluses, IVIG and platelet transfusions, were used in 29% of cases.
Maternal complications were relatively uncommon, with three postpartum hemorrhages reported. Eight women experienced worsening thrombocytopenia after delivery.
Researchers reported 85 vaginal deliveries (80.2%) and 21 cesarean sections (19.8%), with cesarean delivery performed primarily for obstetrical reasons rather than because of ITP.
The authors identified 11 cases of neonatal thrombocytopenia in 107 newborns with a mean platelet countPlatelet count A measure of how many platelets are in the blood. FNAIT is characterized by severely reduced counts in a fetus or newborn. of 22.8 G/L. Seven cases were classified as severe, with platelet counts below 50 G/L. Eight newborns required treatment, most often IVIG.
The researchers concluded that ITP may worsen during pregnancy, particularly in the first trimester, and that approximately one-quarter of pregnancies require treatment. The findings also indicate that vaginal delivery remains the predominant mode of birth and is generally guided by obstetrical considerations.
The results “emphasize the importance of structured multidisciplinary follow-up involving obstetricians, hematologists, neonatologists, and intensivists,” the researchers wrote.
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