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Moderate to severe thrombocytopenia during pregnancy
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 20...
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| Published in: | European journal of obstetrics & gynecology and reproductive biology 2006-09, Vol.128 (1), p.163-168 |
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| container_title | European journal of obstetrics & gynecology and reproductive biology |
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| creator | Parnas, Michal Sheiner, Eyal Shoham-Vardi, Ilana Burstein, Eliezer Yermiahu, Tikva Levi, Itai Holcberg, Gershon Yerushalmi, Ronit |
| description | 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 |
| doi_str_mv | 10.1016/j.ejogrb.2005.12.031 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68839156</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0301211506000911</els_id><sourcerecordid>68839156</sourcerecordid><originalsourceid>FETCH-LOGICAL-c456t-4d6ae5eca91cd297f93f8b361100b723b346811c4c41c720ef30c1d1d0378113</originalsourceid><addsrcrecordid>eNp9kMtKAzEUhoMoWi9vINKN7mbMyW1mNoIUb1Bx4z5kkjM1pZ3UZEbo25vSgjuzSQjf_3POR8g10BIoqPtlicuwiG3JKJUlsJJyOCITqCtWVEqKYzKhnELBAOQZOU9pSfPhvDklZ6Ak51KKCRHvwWE0A06HME34gzG_vmJYt8Fuh7DB3pupG6PvF9NNxEVveru9JCedWSW8OtwX5PP56XP2Wsw_Xt5mj_PCCqmGQjhlUKI1DVjHmqpreFe3XAFQ2laMt1yoGsAKK8BWjGLHqQUHjvIq__MLcrev3cTwPWIa9Noni6uV6TGMSau65g1IlUGxB20MKUXs9Cb6tYlbDVTvZOml3svSO1kamM6ycuzm0D-2a3R_oYOdDNweAJOsWXUxL-_TH1cDUw3bFT3sOcwyfjxGnazH3qLzEe2gXfD_T_ILzqKIsw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68839156</pqid></control><display><type>article</type><title>Moderate to severe thrombocytopenia during pregnancy</title><source>ScienceDirect Journals</source><creator>Parnas, Michal ; Sheiner, Eyal ; Shoham-Vardi, Ilana ; Burstein, Eliezer ; Yermiahu, Tikva ; Levi, Itai ; Holcberg, Gershon ; Yerushalmi, Ronit</creator><creatorcontrib>Parnas, Michal ; Sheiner, Eyal ; Shoham-Vardi, Ilana ; Burstein, Eliezer ; Yermiahu, Tikva ; Levi, Itai ; Holcberg, Gershon ; Yerushalmi, Ronit</creatorcontrib><description>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 <7 at 5
min were noted in infants of mothers with thrombocytopenia (OR
=
6.3, 95% CI
=
1.8–33.8,
p
=
0.001), intrauterine growth restriction (IUGR; OR
=
4.6, 95% CI
=
1.5–19.1,
p
=
0.003), and stillbirth (65/1000 versus 0
p
<
0.001). These adverse perinatal outcomes were found in rare causes of thrombocytopenia such as disseminated intravascular coagulation (DIC), familial thrombotic thrombocytopenic purpura (TTP), anti-phospholipid antibodies (APLA) syndrome, and myeloproliferative disease, and not among patients with GT.
Moderate to severe maternal thrombocytopenia points to a higher degree of severity of the primary disease, which increases perinatal complications. However, the adverse outcome is specifically attributed to preeclampsia, HELLP syndrome, and rare causes, while the perinatal outcome of GT and ITP is basically favorable. Special attention should be given to patients with thrombocytopenia due to preeclampsia, HELLP syndrome, and rarer causes during pregnancy.</description><identifier>ISSN: 0301-2115</identifier><identifier>EISSN: 1872-7654</identifier><identifier>DOI: 10.1016/j.ejogrb.2005.12.031</identifier><identifier>PMID: 16533554</identifier><identifier>CODEN: EOGRAL</identifier><language>eng</language><publisher>Shannon: Elsevier Ireland Ltd</publisher><subject>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</subject><ispartof>European journal of obstetrics & gynecology and reproductive biology, 2006-09, Vol.128 (1), p.163-168</ispartof><rights>2006 Elsevier Ireland Ltd</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-4d6ae5eca91cd297f93f8b361100b723b346811c4c41c720ef30c1d1d0378113</citedby><cites>FETCH-LOGICAL-c456t-4d6ae5eca91cd297f93f8b361100b723b346811c4c41c720ef30c1d1d0378113</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18126921$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16533554$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parnas, Michal</creatorcontrib><creatorcontrib>Sheiner, Eyal</creatorcontrib><creatorcontrib>Shoham-Vardi, Ilana</creatorcontrib><creatorcontrib>Burstein, Eliezer</creatorcontrib><creatorcontrib>Yermiahu, Tikva</creatorcontrib><creatorcontrib>Levi, Itai</creatorcontrib><creatorcontrib>Holcberg, Gershon</creatorcontrib><creatorcontrib>Yerushalmi, Ronit</creatorcontrib><title>Moderate to severe thrombocytopenia during pregnancy</title><title>European journal of obstetrics & gynecology and reproductive biology</title><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><description>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 <7 at 5
min were noted in infants of mothers with thrombocytopenia (OR
=
6.3, 95% CI
=
1.8–33.8,
p
=
0.001), intrauterine growth restriction (IUGR; OR
=
4.6, 95% CI
=
1.5–19.1,
p
=
0.003), and stillbirth (65/1000 versus 0
p
<
0.001). These adverse perinatal outcomes were found in rare causes of thrombocytopenia such as disseminated intravascular coagulation (DIC), familial thrombotic thrombocytopenic purpura (TTP), anti-phospholipid antibodies (APLA) syndrome, and myeloproliferative disease, and not among patients with GT.
Moderate to severe maternal thrombocytopenia points to a higher degree of severity of the primary disease, which increases perinatal complications. However, the adverse outcome is specifically attributed to preeclampsia, HELLP syndrome, and rare causes, while the perinatal outcome of GT and ITP is basically favorable. Special attention should be given to patients with thrombocytopenia due to preeclampsia, HELLP syndrome, and rarer causes during pregnancy.</description><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>Case-Control Studies</subject><subject>Diseases of mother, fetus and pregnancy</subject><subject>Female</subject><subject>Gestational thrombocytopenia</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>HELLP</subject><subject>HELLP Syndrome - blood</subject><subject>Hematologic and hematopoietic diseases</subject><subject>Humans</subject><subject>Medical sciences</subject><subject>Moderate to severe thrombocytopenia</subject><subject>Platelet diseases and coagulopathies</subject><subject>Pre-Eclampsia - blood</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications - blood</subject><subject>Pregnancy Outcome</subject><subject>Pregnancy. Fetus. Placenta</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Thrombocytopenia - complications</subject><issn>0301-2115</issn><issn>1872-7654</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><recordid>eNp9kMtKAzEUhoMoWi9vINKN7mbMyW1mNoIUb1Bx4z5kkjM1pZ3UZEbo25vSgjuzSQjf_3POR8g10BIoqPtlicuwiG3JKJUlsJJyOCITqCtWVEqKYzKhnELBAOQZOU9pSfPhvDklZ6Ak51KKCRHvwWE0A06HME34gzG_vmJYt8Fuh7DB3pupG6PvF9NNxEVveru9JCedWSW8OtwX5PP56XP2Wsw_Xt5mj_PCCqmGQjhlUKI1DVjHmqpreFe3XAFQ2laMt1yoGsAKK8BWjGLHqQUHjvIq__MLcrev3cTwPWIa9Noni6uV6TGMSau65g1IlUGxB20MKUXs9Cb6tYlbDVTvZOml3svSO1kamM6ycuzm0D-2a3R_oYOdDNweAJOsWXUxL-_TH1cDUw3bFT3sOcwyfjxGnazH3qLzEe2gXfD_T_ILzqKIsw</recordid><startdate>20060901</startdate><enddate>20060901</enddate><creator>Parnas, Michal</creator><creator>Sheiner, Eyal</creator><creator>Shoham-Vardi, Ilana</creator><creator>Burstein, Eliezer</creator><creator>Yermiahu, Tikva</creator><creator>Levi, Itai</creator><creator>Holcberg, Gershon</creator><creator>Yerushalmi, Ronit</creator><general>Elsevier Ireland Ltd</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20060901</creationdate><title>Moderate to severe thrombocytopenia during pregnancy</title><author>Parnas, Michal ; Sheiner, Eyal ; Shoham-Vardi, Ilana ; Burstein, Eliezer ; Yermiahu, Tikva ; Levi, Itai ; Holcberg, Gershon ; Yerushalmi, Ronit</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-4d6ae5eca91cd297f93f8b361100b723b346811c4c41c720ef30c1d1d0378113</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>Case-Control Studies</topic><topic>Diseases of mother, fetus and pregnancy</topic><topic>Female</topic><topic>Gestational thrombocytopenia</topic><topic>Gynecology. Andrology. Obstetrics</topic><topic>HELLP</topic><topic>HELLP Syndrome - blood</topic><topic>Hematologic and hematopoietic diseases</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Moderate to severe thrombocytopenia</topic><topic>Platelet diseases and coagulopathies</topic><topic>Pre-Eclampsia - blood</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Complications - blood</topic><topic>Pregnancy Outcome</topic><topic>Pregnancy. Fetus. Placenta</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Thrombocytopenia - complications</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Parnas, Michal</creatorcontrib><creatorcontrib>Sheiner, Eyal</creatorcontrib><creatorcontrib>Shoham-Vardi, Ilana</creatorcontrib><creatorcontrib>Burstein, Eliezer</creatorcontrib><creatorcontrib>Yermiahu, Tikva</creatorcontrib><creatorcontrib>Levi, Itai</creatorcontrib><creatorcontrib>Holcberg, Gershon</creatorcontrib><creatorcontrib>Yerushalmi, Ronit</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parnas, Michal</au><au>Sheiner, Eyal</au><au>Shoham-Vardi, Ilana</au><au>Burstein, Eliezer</au><au>Yermiahu, Tikva</au><au>Levi, Itai</au><au>Holcberg, Gershon</au><au>Yerushalmi, Ronit</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Moderate to severe thrombocytopenia during pregnancy</atitle><jtitle>European journal of obstetrics & gynecology and reproductive biology</jtitle><addtitle>Eur J Obstet Gynecol Reprod Biol</addtitle><date>2006-09-01</date><risdate>2006</risdate><volume>128</volume><issue>1</issue><spage>163</spage><epage>168</epage><pages>163-168</pages><issn>0301-2115</issn><eissn>1872-7654</eissn><coden>EOGRAL</coden><abstract>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 <7 at 5
min were noted in infants of mothers with thrombocytopenia (OR
=
6.3, 95% CI
=
1.8–33.8,
p
=
0.001), intrauterine growth restriction (IUGR; OR
=
4.6, 95% CI
=
1.5–19.1,
p
=
0.003), and stillbirth (65/1000 versus 0
p
<
0.001). These adverse perinatal outcomes were found in rare causes of thrombocytopenia such as disseminated intravascular coagulation (DIC), familial thrombotic thrombocytopenic purpura (TTP), anti-phospholipid antibodies (APLA) syndrome, and myeloproliferative disease, and not among patients with GT.
Moderate to severe maternal thrombocytopenia points to a higher degree of severity of the primary disease, which increases perinatal complications. However, the adverse outcome is specifically attributed to preeclampsia, HELLP syndrome, and rare causes, while the perinatal outcome of GT and ITP is basically favorable. Special attention should be given to patients with thrombocytopenia due to preeclampsia, HELLP syndrome, and rarer causes during pregnancy.</abstract><cop>Shannon</cop><pub>Elsevier Ireland Ltd</pub><pmid>16533554</pmid><doi>10.1016/j.ejogrb.2005.12.031</doi><tpages>6</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0301-2115 |
| ispartof | European journal of obstetrics & gynecology and reproductive biology, 2006-09, Vol.128 (1), p.163-168 |
| issn | 0301-2115 1872-7654 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_68839156 |
| source | ScienceDirect Journals |
| 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 |
| title | Moderate to severe thrombocytopenia during pregnancy |
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