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Frequency of immune thrombocytopenia in newborns: a prospective study.
Immune Thrombocytopenia Working Group
M Dreyfus, C Kaplan, E Verdy, N Schlegel, I Durand-Zaleski and G Tchernia
Department of Biological Hematology, Hopital Bicetre, Le Kremlin- Bicetre,
France.
Thrombocytopenia is a common condition in distressed newborns, but little
is known about thrombocytopenia in an unselected cohort of neonates. In an
attempt to address this issue, a multicenter prospective study was
conducted in three obstetrical wards of AP-HP in Paris. We found the
frequency of neonatal thrombocytopenia (<150 x 10(9)/L) to approximate
0.9% (48 of 5,632 appropriate samples). An immune mechanism was likely to
be the cause of thrombocytopenia in 10 of the 33 cases studied, implying an
incidence of 0.3% of immune neonatal thrombocytopenia in the general
population. The frequency of alloimmune thrombocytopenia was 1.5/1,000
liveborn neonates, and 1/1,000 when considering anti-HPA-1a
allo-immunization. Because thrombocytopenia, whatever its cause, was often
silent and delayed, it appears that the only way to detect neonatal
thrombocytopenia in time to prevent its potential disastrous complications
would be to perform a systematic neonatal blood sampling for platelet
count. All cases of ascertained thrombocytopenia should then be screened
for an immune mechanism to enable early detection of autoimmune diseases in
mothers and careful monitoring of subsequent pregnancies and deliveries,
leading to appropriate prevention of potential severe deleterious effects
in the offspring.
Volume 89,
Issue 12,
pp. 4402-4406,
06/15/1997
Copyright © 1997 by The American Society of Hematology
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