Perinatal outcome for pregnancies complicated with thrombocytopenia.
BACKGROUND
Thrombocytopenia affects about 10% of all pregnancies. Preeclampsia/HELLP syndrome induced thrombocytopenia may associate perinatal morbidity, preterm delivery, or low-birth-weight newborns.


OBJECTIVE
To assess perinatal outcome and complications of pregnancy in women presenting with thrombocytopenia.


METHODS
We retrospectively analyzed 936 consecutive pregnant women admitted during a 6-month period.


RESULTS
Incidence of thrombocytopenia in pregnancy was 11.11% (104/936). Thrombocytopenia represented a risk factor for premature delivery - highest risk for severe thrombocytopenia (RR=8.69, p<0.01). Thrombocytopenic preeclampsia or HELLP syndrome associated the highest rates of prematurity (RR=7.97, p=0.00, respectively 12.32). Thrombocytopenia also represented a risk factor for low-birth-weight newborns, especially severe thrombocytopenia - 2047.50 ± 938.98 g (p=0.02) versus 3224.86 ± 496.00 g in controls. Again, thrombocytopenic preeclampsia was significantly associated with low-birth-weight newborns (RR=11.94, p=0.00), with medium weight of 2462.05 ± 794.54 g versus 2932.37 ± 708.91 g in thrombocytopenic pregnancies, respectively 3224.86 ± 496.00 g (p=0.00) in normal pregnancies.


CONCLUSIONS
Thrombocytopenia in pregnancy was associated with perinatal morbidity, with the strongest association for preeclampsia and HELLP syndrome - for both prematurity and low-birth-weight: the lower the platelet count, the higher the risks for the fetus/newborn. Therefore, we strongly recommend close surveillance of thrombocytopenic mothers and their babies, in order to establish the etiology and the best moment for intervention.
Hematology Department, Emergency University Hospital Bucharest, Elias University Emergency Hospital, Bucharest, Romania. minodorel@yahoo.com
Minodora
M
Onisâi
Ana-Maria
AM
Vlădăreanu
Caterina
C
Delcea
Mihai
M
Ciorăscu
Horia
H
Bumbea
Anca
A
Nicolescu
Irina
I
Voican
Alexandru
A
Filipescu
Octavian
O
Rotaru
Radu
R
Vlădăreanu
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D017359:HELLP Syndrome / Q000453:epidemiology / Q000401:mortality; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000453:epidemiology / Q000401:mortality; D009017:Morbidity; D007752:Obstetric Labor, Premature / Q000453:epidemiology / Q000401:mortality; D054238:Perinatal Mortality; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000401:mortality; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology* / Q000401:mortality; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012189:Retrospective Studies; D013921:Thrombocytopenia / Q000453:epidemiology* / Q000401:mortality; D055815:Young Adult