Document Detail


Fetal thrombocytopenia and its relation to maternal thrombocytopenia.
MedLine Citation:
PMID:  8413457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Neonates with severe thrombocytopenia can have bleeding leading to death or lifelong residual defects. The predictors, frequency, and consequences of fetal thrombocytopenia are not known, nor is it known if there are maternal clinical features that could predict fetal thrombocytopenia. METHODS: We conducted a seven-year cross-sectional study in which platelet counts were determined in newborns' umbilical-cord blood and blood obtained from their mothers at consecutive deliveries in one obstetrical unit. The relations of the umbilical-cord platelet count to maternal risk factors were determined. RESULTS: Platelet counts were determined in blood samples from 15,471 mothers and 15,932 newborn infants. The cord-blood platelet count was less than 50,000 per cubic millimeter in 19 infants (0.12 percent; 95 percent confidence interval, 0.07 to 0.19 percent), whereas the platelet count was less than 150,000 per cubic millimeter in 6.6 percent of the mothers (95 percent confidence interval, 6.2 to 7.0 percent). One infant among those born to 756 mothers with incidental thrombocytopenia, 5 infants among those born to 1414 mothers with hypertension, and 4 infants among those born to 46 mothers with idiopathic thrombocytopenic purpura had cord-blood platelet counts between 20,000 and 50,000 per cubic millimeter. Only 6 infants (0.04 percent; 95 percent confidence interval, 0.01 to 0.08 percent) had cord-blood platelet counts of less than 20,000 per cubic millimeter; all their mothers were among the 18 whose 19 fetuses were at risk for neonatal alloimmune thrombocytopenia. Two of these infants had in utero intracranial hemorrhage. In addition, 3 infants born to these 18 women had cord-blood platelet counts between 20,000 and 50,000 per cubic millimeter; there was 1 stillbirth due to intracranial hemorrhage. CONCLUSIONS: Moderate-to-severe fetal thrombocytopenia is a rare event. The only severely affected neonates with morbidity or mortality due to this condition are those born to mothers with antiplatelet alloantibodies.
Authors:
R F Burrows; J G Kelton
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The New England journal of medicine     Volume:  329     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1993-11-18     Completed Date:  1993-11-18     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1463-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Obstetrics and Gynecology, McMaster University Medical Centre, Hamilton, Ont., Canada.
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MeSH Terms
Descriptor/Qualifier:
Blood Platelets / immunology
Confidence Intervals
Cross-Sectional Studies
Female
Fetal Blood
Fetal Diseases / blood*
Humans
Infant, Newborn
Isoantibodies / blood
Platelet Count
Pregnancy
Pregnancy Complications, Hematologic / blood*,  immunology
Prospective Studies
Thrombocytopenia / blood*,  congenital*
Chemical
Reg. No./Substance:
0/Isoantibodies
Comments/Corrections
Comment In:
N Engl J Med. 1994 Mar 31;330(13):940-1   [PMID:  8114878 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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