title: Association of severe thrombocytopenia and poor prognosis in pregnancies with aplastic anemia.
abstract: OBJECTIVE
  We sought to estimate the risks of adverse obstetric outcomes and disease outcomes associated with severe thrombocytopenia in pregnant women with aplastic anemia (AA).
  
  
  METHODS
  In a retrospective study, we compared demographics, clinical characteristics, laboratory results, and outcomes between severe thrombocytopenia (ST) and non-severe thrombocytopenia (non-ST) groups comprising pregnant women with AA.
  
  
  RESULTS
  Of 61 AA patients, 43 (70%) were diagnosed as AA before pregnancy and 18 (30%) were AA during pregnancy. The ST group exhibited lower gestational age at nadir of platelet count (26.0 versus 37.0 weeks, p<0.001) and at delivery (37.3 versus 39.1 weeks, p = 0.008), and a higher rate of bleeding gums (33.8 versus 7.7%, p = 0.015) than the non-ST group. In addition, the ST group exhibited more transfusions during pregnancy (72.7 versus 15.4%, p<0.001) and postpartum period (45.0 versus 2.7%, p<0.001), and more bone marrow transplant after delivery (25.0 versus 0.0%, p<0.001) than the non-ST group. The ST group had a higher odds ratio of composite disease complications (OR, 9.63; 95% CI, 2.82-32.9; p<0.001) and composite obstetric complications (OR, 6.78; 95% CI, 2.11-21.8; p = 0.001) than the non-ST group.
  
  
  CONCLUSIONS
  Severe thrombocytopenia is more associated with obstetric and disease complications than is non-severe thrombocytopenia in pregnant women with AA.
authors: Department of Obstetrics and Gynecology, College of Medicine, the Catholic University of Korea, Seoul, Korea.
authors: Jae Eun
authors: JE
authors: Shin
authors: Department of Obstetrics and Gynecology, College of Medicine, the Catholic University of Korea, Seoul, Korea.
authors: Young
authors: Y
authors: Lee
authors: Department of Obstetrics and Gynecology, College of Medicine, the Catholic University of Korea, Seoul, Korea.
authors: Sa Jin
authors: SJ
authors: Kim
authors: Department of Obstetrics and Gynecology, College of Medicine, the Catholic University of Korea, Seoul, Korea.
authors: Jong Chul
authors: JC
authors: Shin
mesh_terms: D000328:Adult; D000741:Anemia, Aplastic / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D016026:Bone Marrow Transplantation; D002585:Cesarean Section / Q000706:statistics & numerical data; D036861:Delivery, Obstetric / Q000706:statistics & numerical data; D005260:Female; D005865:Gestational Age; D006801:Humans; D016017:Odds Ratio; D010976:Platelet Count; D017713:Platelet Transfusion; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000175:diagnosis* / Q000473:pathology / Q000517:prevention & control; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013921:Thrombocytopenia / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy