Moderate to severe thrombocytopenia during pregnancy

• Published in: European journal of obstetrics & gynecology and reproductive biology 2006-09, Vol.128 (1), p.163-168
• Main Authors: Parnas, Michal, Sheiner, Eyal, Shoham-Vardi, Ilana, Burstein, Eliezer, Yermiahu, Tikva, Levi, Itai, Holcberg, Gershon, Yerushalmi, Ronit
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Case-Control Studies; Diseases of mother, fetus and pregnancy; Female; Gestational thrombocytopenia; Gynecology. Andrology. Obstetrics; HELLP; HELLP Syndrome - blood; Hematologic and hematopoietic diseases; Humans; Medical sciences; Moderate to severe thrombocytopenia; Platelet diseases and coagulopathies; Pre-Eclampsia - blood; Preeclampsia; Pregnancy; Pregnancy Complications - blood; Pregnancy Outcome; Pregnancy. Fetus. Placenta; Retrospective Studies; Risk Factors; Thrombocytopenia - complications
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2005.12.031

The objective was to investigate obstetric risk factors, complications, and outcomes of pregnancies complicated by moderate to severe thrombocytopenia. A retrospective case-control study comparing 199 pregnant women with moderate to severe thrombocytopenia (platelet count below 100 × 10 9/l) with 201 pregnant women without thrombocytopenia, who delivered between January 2003 to April 2004. Stratified analysis, using the Mantel–Haenszel procedure was performed in order to control for confounders. The main causes of thrombocytopenia were gestational thrombocytopenia (GT) (59.3%), immune thrombocytopenic purpura (ITP) (11.05%), preeclampsia (10.05%), and HELLP (Hemolysis, elevated liver enzymes and low platelet count) syndrome (12.06%). Women with thrombocytopenia were significantly older (30.7 ± 5.9 versus 28.7 ± 5.7; p = 0.001) compared with patients without thrombocytopenia, and had higher rates of labor induction (OR = 4.0, 95% CI = 2.2–7.6, p < 0.001) and preterm deliveries (OR = 3.5, 95% CI = 1.9–6.5, p < 0.001). Even after controlling for labor induction, using the Mantel–Haenszel technique, thrombocytopenia was significantly associated with preterm delivery (weighted OR = 3.14, 95% CI = 1.7–6.0, p < 0.001). Higher rates of placental abruption were found in pregnant women with thrombocytopenia (OR = 6.2, 95% CI = 1.7–33.2, p = 0.001). In a comparison of perinatal outcomes, higher rates of Apgar scores