Alloimmune Thrombocytopenia of the Newborn: Neurodevelopmental Sequelae

Inés A. Bonacossa; Leslie J. Jocelyn

doi:10.1055/s-2007-994366

American Journal of Perinatology, Table of Contents

Am J Perinatol 1996; 13(4): 211-215
DOI: 10.1055/s-2007-994366

ORIGINAL ARTICLE

Alloimmune Thrombocytopenia of the Newborn: Neurodevelopmental Sequelae

Inés A. Bonacossa, Leslie J. Jocelyn

Platelet Serology Laboratory, Canadian Red Cross Blood Transfusion Service, Winnipeg, Manitoba, and University of Manitoba, Department of Child Health, Section of Child Development, Children's Hospital, Health Sciences Center, Winnipeg, Manitoba, Canada

Abstract

ABSTRACT

Alloimmune thrombocytopenia of the newborn (AITN) is due to the transplacental passage of maternal antibodies directed against fetal platelet antigens, most commonly PLA₁ (HPA-1a). Sensitization and clinical manifestations of disease can occur in the first pregnancy. It carries a mortality rate of 15%, usually due to intracranial hemorrhage (ICH). Twenty-four cases of AITN were reviewed, five of whom had radiological evidence of ICH in utero. Petechiae and/or bruising were present in 14 babies. Platelet counts at birth ranged from 5 to 206 × 10⁹/L. One infant died. The duration of follow-up for the four survivors of ICH ranged from 15 to 71 months. All had serious neurodevelopmental sequelae, including severe mental retardation, cortical blindness, seizures, and cerebral palsy. The emotional and financial cost created by the care of these children is immeasurable. Steps to identify and prevent AITN should be part of routine prenatal care if we are to reduce the morbidity and mortality caused by this disorder.

Keywords

Alloimmune thrombocytopenia - neurodevelopmental sequelae - maternal antibodies

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