Perinatal outcome of pregnancies complicated by immune thrombocytopenia

Immune thrombocytopenia (ITP) is an autoimmune disorder that leads to premature destruction of antibody-coated platelets. This study evaluated perinatal outcome and medications used for pregnancies complicated by ITP.

Medical records of 132 pregnancies belonged to 125 parturients with ITP who delivered between March 2001 and January 2011 were reviewed. Cases were included if diagnosed before pregnancy or if their platelet counts (PCs) were less than 80,000/µL during pregnancy without any other cause. Maternal and fetal outcomes were compared.

Fifty six mothers (42.1%) had PC<50,000, 18 women (13.5%) developed preeclampsia and 15 (11.3%) were diabetics. Corticosteroid was used for120 cases (90.9%) and intravenous immunoglobulin for 14 women (10.5%). PCs of 114 neonates were available in the charts and 84 (83.2%) had PC>150,000/µL. Three neonates (2.3%) had PC<50 000, 31 neonates (23.3%) had preterm births and 32 (24.1%) needed NICU admissions. Fifty seven cases of ITP (43.2%) were diagnosed before pregnancy and 75 (56.8%) were diagnosed during pregnancy. There were 2 intrauterine fetal deaths and higher NICU admissions, 20 (34.48%) versus 12 (16%) in the first group (p=0.01).

Perinatal outcome of pregnancies with ITP is generally good. However neonates born from parturients with chronic ITP needed more NICU admissions.