Pregnancy outcomes in myeloproliferative neoplasms: UK prospective cohort study.
The reported higher risk of maternal and fetal complications in women with myeloproliferative neoplasms (MPN) poses challenge during pregnancy. A national prospective study of maternal and fetal outcomes of pregnant women with a diagnosis of MPN was undertaken via the United Kingdom Obstetric Surveillance System between January 2010 and December 2012. Fifty-eight women with a diagnosis of MPN were identified; 47 (81%) essential thrombocythaemia, five (9%) polycythaemia vera, five (9%) myelofibrosis and one (2%) MPN-unclassified. There were 58 live births. The incidence of miscarriage was 1·7/100 (95% confidence interval [CI]: 0·04-9·24) and the perinatal mortality rate was 17/1000 (95% CI: 0·44-92·36) live and stillbirths. Incidence of maternal complications was 9% (5/57) pre-eclampsia, 9% (5/57) post-partum haemorrhage and 3·5% (2/57) post-partum haematoma. There were no maternal deaths or thrombotic events. Delivery was induced in 45% (24/53) of women and the Caesarean section rate was 45% (24/53). The majority (85%, 45/53) delivered at term (>37 weeks gestation). Twenty-two percent (12/54) of neonates were below the 10% centile for growth and 13% (7/54) required admission to a neonatal care-unit; there were no neonatal deaths. The findings of this large, UK prospective study suggests women with MPN appear to have successful pregnancies with better outcomes than would be anticipated from the literature.
Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, London, UK. samah.alimam@gstt.nhs.uk.
Samah
S
Alimam
Women's Health Academic Centre, King's College London, London, UK.
Susan
S
Bewley
Women's Health Academic Centre, King's College London, London, UK.
Lucy C
LC
Chappell
Perinatal Epidemiology Unit, University of Oxford, Oxford, UK.
Marian
M
Knight
Women's Health Academic Centre, King's College London, London, UK.
Paul
P
Seed
Department of Obstetrics and Gynaecology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Gabriella
G
Gray
Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Claire
C
Harrison
Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Susan
S
Robinson
D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006801:Humans; D015994:Incidence; D009196:Myeloproliferative Disorders / Q000453:epidemiology*; D011159:Population Surveillance; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012307:Risk Factors; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
essential thrombocythaemia; myelofibrosis; myeloproliferative neoplasms; polythaemia vera; pregnancy