Contemporary management of neonatal alloimmune thrombocytopenia: good outcomes in the intravenous immunoglobulin era: results from the Australian neonatal alloimmune thrombocytopenia registry. (18th October 2017)

• Record Type: Journal Article
• Authors: Crighton, Gemma L.; Scarborough, Ri; McQuilten, Zoe K.; Phillips, Louise E.; Savoia, Helen F.; Williams, Bronwyn; Holdsworth, Rhonda; Henry, Amanda; Wood, Erica M.; Cole, Stephen A.
• Is Part Of: Journal of maternal-fetal & neonatal medicine. Volume 30:Number 20(2017)
• Page Start: 2488
• Page End: 2494
• Publication Date: 2017-10-18
• Subjects: Fetomaternal/neonatal alloimmune thrombocytopenia -- human platelet antigen -- intracranial haemorrhage -- neonatal thrombocytopenia -- intravenous immunoglobulin; Obstetrics -- Periodicals; Perinatology -- Periodicals; Infants (Newborn) -- Diseases -- Periodicals; Neonatology -- Periodicals; 618.2
• DOI: 10.1080/14767058.2016.1253064
• Languages: English
• ISSNs: 1476-7058

Abstract

Abstract: Objective : To describe the natural history, antenatal and postnatal therapy, and clinical outcomes of Australian patients with fetomaternal/neonatal alloimmune thrombocytopenia (NAIT) recorded in the Australian NAIT registry. Methods : Analysis of registry data of Australian mothers treated antenatally for NAIT and any fetus/newborn with thrombocytopenia (TCP) and maternal human platelet antigen (HPA) antibodies. Results : Ninety four potential cases (91 pregnancies; three twin pregnancies) were registered between December 2004 and September 2015 with 76 confirmed or treated as NAIT. NAIT was frequently unanticipated (44 cases, 58%), whilst 32 cases (42%) were anticipated due to personal or family history. In 70/76 cases, the diagnosis of NAIT was made based on HPA antibody results; anti-HPA-1a was most commonly detected (58/70, 82%), followed by anti-HPA-5b (5/70, 7%). Intracranial haemorrhage (ICH) was detected in seven cases (9%). Maternal antenatal therapy resulted in improved clinical outcomes. For antenatally treated cases, whilst 10/29 (34%) neonates had severe TCP, only one ICH was detected. Conclusions : This study provides data on contemporary "real world" management of Australian mothers and babies with NAIT. Antenatal IVIG therapy was associated with better neonatal outcomes. Maternal side-effects and treatment costs were substantial.