A study recently published in the Journal of Clinical Medicine found that pregnant women with severe thrombocytopenia and their babies are at a higher risk of experiencing various complications, including symptoms consistent with fetal and neonatal alloimmune thrombocytopenia (FNAIT).
While the association between maternal thrombocytopenia and neonatal outcomes has been investigated, few studies have evaluated whether the cause or severity of maternal thrombocytopenia is linked to certain complications.
The study included 182 pregnant women who were diagnosed with thrombocytopenia and delivered at two South Korean hospitals between 2009 and 2019. Of the participants, 107 had moderate and 75 had severe thrombocytopenia.
Gestational thrombocytopenia, which is not typically associated with adverse outcomes, was more commonly seen in patients with moderate thrombocytopenia. On the other hand, conditions such as immune thrombocytopenic purpura (ITP) and aplastic anemia were more common among those with severe thrombocytopenia.
Read more about FNAIT signs and symptoms
Women with severe thrombocytopenia experienced more blood loss during delivery and had higher transfusion volumes than those in the moderate group. Additionally, 9.3% of neonates born to women in the severe group also had severe thrombocytopenia, compared to just 1.1% of neonates born to women in the moderate group.
Notably, maternal ITP occurred in 86.3% of neonatal thrombocytopenia cases. Other maternal conditions including pre-eclampsia, aplastic anemia and lupus were not linked to neonatal thrombocytopenia.
Although the authors did not specifically assess pregnancies affected by FNAIT, the study highlights the potential overlap between diseases such as FNAIT and ITP and the need for careful monitoring.
“These findings highlight the importance of recognizing that women with severe
or immune-mediated thrombocytopenia, and their neonates, are at a higher risk of adverse outcomes,” the authors concluded. “A multidisciplinary approach including obstetricians, hematologists and neonatologists may help optimize clinical outcomes and reduce maternal and neonatal morbidity.”
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