Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial hemorrhage in pregnancies complicated by autoimmune thrombocytopenia
Maternal characteristics and risk of severe neonatal thrombocytopenia and intracranial hemorrhage in pregnancies complicated by autoimmune thrombocytopenia
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DOI：
10.1016/s0002-9378(97)70454-x
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发表时间：
1997-07-01
影响因子：
9.8
通讯作者：
Kelly, TF
中科院分区：
文献类型：
--
作者：
Payne, SD;Resnik, R;Kelly, TF
目的：患有自身免疫性血小板减少症的女性的产前和产时管理存在争议。目前的方法强调努力确定可预测严重新生儿血小板减少症的母亲特征，或测量胎儿血小板计数并对被认为有新生儿颅内出血风险的患者进行剖宫产。在当前的研究中，我们回顾了我们在孕产妇自身免疫性血小板减少症和新生儿结局方面的经验。 研究设计：对加利福尼亚州圣地亚哥三个主要医疗中心 10 年来患有自身免疫性血小板减少症的 55 例妊娠进行了评估。对母亲特征和新生儿结局进行了评估，并与其他最近报告中的结果进行了比较。数据提交至Fisher精确（双尾）、chi(2)和Student t检验，并进行线性回归分析变量之间的关联。 结果：母亲特征，包括血小板计数、抗血小板抗体的存在、自身免疫性血小板减少症的既往病史和皮质类固醇治疗，不能预测严重的新生儿血小板减少症。母亲脾切除史与胎儿血小板计数显着相关
OBJECTIVE: The antenatal and intrapartum management of women with autoimmune thrombocytopenia is controversial. The current approach emphasizes an effort to identify maternal characteristics predictive of severe neonatal thrombocytopenia or to measure fetal platelet counts and perform cesarean section in patients considered to be at risk for neonatal intracranial hemorrhage. In the current study we review our experience with maternal autoimmune thrombocytopenia and neonatal outcome.STUDY DESIGN: Fifty-five pregnancies with autoimmune thrombocytopenia over a 10-year period in three major medical centers in San Diego, California, were evaluated. Maternal characteristics and neonatal outcomes were assessed and compared with those in other recent reports. Data were submitted to Fisher's exact (two-tailed), chi(2), and Student t tests, with linear regression performed to analyze the association between variables.RESULTS: Maternal characteristics including platelet count, presence of antiplatelet antibody, antecedent history of autoimmune thrombocytopenia, and corticosteroid therapy were not predictive of severe neonatal thrombocytopenia. Maternal history of splenectomy was significantly correlated with fetal platelet counts