title: Nationwide study of idiopathic thrombocytopenic purpura in pregnant women and the clinical influence on neonates.
abstract: Idiopathic thrombocytopenic purpura (ITP) occurs more commonly in young women during the reproductive years. To obtain information for management of ITP in pregnancy, we performed a nationwide retrospective survey. Findings from a total of 284 pregnant women with ITP and their 286 newborn infants were available for analysis. The bleeding tendency at delivery was managed chiefly with corticosteroid, intravenous high-dose gamma-globulin, and platelet transfusion. Maternal complications occurred in 77 cases (27.1%) and were frequently seen in cases with poor control of ITP. Neonatal abnormalities, which were not influenced by the clinical state of the mother, occurred at a frequency of 17.8%. Thrombocytopenia in neonates occurred in 48 cases (22.4%), and bleeding tendency was found in 16 cases (6.3%) without severe bleeding. Prediction of thrombocytopenia in neonates was difficult. However, infants from splenectomized mothers with well-controlled ITP showed thrombocytopenia more frequently than those from nonsplenectomized mothers. Mothers treated with steroids at doses greater than 15 mg/day showed a high frequency of maternal complications and fetal abnormal body weight. These observations will be useful in the management of pregnant women with ITP and their infants.
authors.affiliation: Department of Clinical Pharmaceutical Science, Graduate School of Medicine, Hiroshima University, Japan. fujimura@hiroshima-u.ac.jp
authors.forename: Kingo
authors.initials: K
authors.lastname: Fujimura
authors.forename: Yuka
authors.initials: Y
authors.lastname: Harada
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Fujimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kuramoto
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Akatsuka
authors.forename: Kazuo
authors.initials: K
authors.lastname: Dan
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Omine
authors.forename: Hideaki
authors.initials: H
authors.lastname: Mizoguchi
mesh_terms: D000014:Abnormalities, Drug-Induced / Q000453:epidemiology*; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D003625:Data Collection; D019468:Disease Management; D005260:Female; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007564:Japan / Q000453:epidemiology; D010976:Platelet Count; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology* / Q000628:therapy; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones