A study recently published in Developmental Medicine & Child Neurology showed that intracranial hemorrhage (ICH), a complication of fetal and neonatal alloimmune thrombocytopenia (FNAIT), can result in long-term neurological impairment.
The authors investigated patients diagnosed with ICH during the perinatal period, which they defined as the time frame between 20 weeks gestation and 28 days postpartum. ICH may occur in up to 25% of patients with FNAIT and is associated with chronic neurological dysfunction.
The study included 68 patients who were diagnosed with ICH at the Tel Aviv Medical Center from January 2014 to November 2022. Of the participants, 22 were diagnosed prenatally and 46 were diagnosed postnatally.
The most common type of ICH identified was intraventricular hemorrhage (63.2%), which occurs in the portion of the brain containing the cerebrospinal fluid. Infants with a prenatal ICH diagnosis were more likely to have intraventricular hemorrhage than those with a postnatal diagnosis. Additionally, 8 patients were found to have genetic variants likely associated with ICH.
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Neurological follow-up assessments were performed between 1 year and 9 years and 5 months of age using the Pediatric Stroke Outcome Measure (PSOM). Among the participants, 29 had normal neurological outcomes, 12 experienced mild impairment, 11 showed moderate impairment and 16 exhibited severe impairment.
Findings also revealed that 47.1% of participants were diagnosed with developmental delay, 42.6% were diagnosed with cerebral palsy and 19.1% were diagnosed with remote epilepsy during the follow-up period.
Notably, no difference in outcomes was observed between those diagnosed with ICH prenatally and those diagnosed postnatally. However, younger maternal age was linked to adverse neurological outcomes, including cognition and behavior.
“These findings highlight the importance of early neuroimaging assessment to enable timely intervention and aid in accurately estimating prognosis,” the authors concluded.
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