Effect of pregnancy on the course of immune thrombocytopenia: a retrospective study of 118 pregnancies in 82 women. (24th June 2014)

• Record Type: Journal Article
• Authors: Loustau, Valentine; Debouverie, Odile; Canoui‐Poitrine, Florence; Baili, Lilia; Khellaf, Mehdi; Touboul, Claudine; Languille, Laetitia; Loustau, Marine; Bierling, Philippe; Haddad, Bassam; Godeau, Bertrand; Pourrat, Olivier; Michel, Marc
• Is Part Of: British journal of haematology. Volume 166:Number 6(2014:Sep.)
• Page Start: 929
• Page End: 935
• Publication Date: 2014-06-24
• Subjects: Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.12976
• Languages: English
• ISSNs: 0007-1048

Abstract

<abstract abstract-type="main" id="bjh12976-abs-0001"> <title>Summary</title> <p>In women with pre‐existing immune thrombocytopenic purpura (ITP), the effect of pregnancy on the course of the disease is poorly known. We performed a dual‐centre retrospective cohort study of 118 pregnancies in 82 women with primary ITP. In early pregnancy, the platelet count was &lt;100 × 10⁹/l in 35·6% of pregnancies. During pregnancy the median platelet count nadir was 66 × 10⁹/l (25th–75th percentile: 42–117), with platelet count &lt;30 × 10⁹/l for 26 pregnancies (22%). In 49% of pregnancies, a significant decrease of the platelet count required treatment at least transiently in preparation for delivery. At the time of delivery, the median platelet count was 110 × 10⁹/l (77–155). Compared to before pregnancy, at 3 months post‐partum, only 11% of pregnancies [95% confidence interval (95% CI): 6·8–20·2] showed disease worsening. Previous splenectomy was the only factor significantly associated with ITP worsening after pregnancy (53·9% vs. 10·3%, <italic>P</italic> &lt; 0·001). For 8·3% of the pregnancies (95% CI: 3·8–15·1), neonatal thrombocytopenia required treatment, especially in case of previous maternal splenectomy (adjusted odds ratio 16·7, 95% CI: 2·61–106). The overall risk of exacerbation of ITP and severe thrombocytopenia during pregnancy is acceptable.</p> </abstract>