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Lookzadeh, M., Mirjalili, S., Ekraminasab, S. (2020). Immune and Non-Immune Etiology of Thrombocytopenia: Neonatal and Maternal Causes. Shahid Sadoughi University of Medical Sciences- Journal Management System, 3(2), 78-86. doi: 10.18502/wjpn.v3i2.6158
Mohamad Hosein Lookzadeh; Seyed Reza Mirjalili; Sedigheh Ekraminasab. "Immune and Non-Immune Etiology of Thrombocytopenia: Neonatal and Maternal Causes". Shahid Sadoughi University of Medical Sciences- Journal Management System, 3, 2, 2020, 78-86. doi: 10.18502/wjpn.v3i2.6158
Lookzadeh, M., Mirjalili, S., Ekraminasab, S. (2020). 'Immune and Non-Immune Etiology of Thrombocytopenia: Neonatal and Maternal Causes', Shahid Sadoughi University of Medical Sciences- Journal Management System, 3(2), pp. 78-86. doi: 10.18502/wjpn.v3i2.6158
Lookzadeh, M., Mirjalili, S., Ekraminasab, S. Immune and Non-Immune Etiology of Thrombocytopenia: Neonatal and Maternal Causes. Shahid Sadoughi University of Medical Sciences- Journal Management System, 2020; 3(2): 78-86. doi: 10.18502/wjpn.v3i2.6158

Immune and Non-Immune Etiology of Thrombocytopenia: Neonatal and Maternal Causes

World Journal of Peri and Neonatology
Volume 3, Issue 2, December 2020, Pages 78-86    PDF (497.99 K)
Document Type: Scientific Review
DOI: 10.18502/wjpn.v3i2.6158
Authors
Mohamad Hosein Lookzadeh1; Seyed Reza Mirjalili1; Sedigheh Ekraminasab* 1, 2
1Mother and Newborn Health Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
2Laboratory Hematology and Blood Banking Department, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract
Neonatal thrombocytopenia (NT) is a common hemostatic abnormalitiy among newborn in the NICU, which increases with the degree of prematurity. It is well documented that this disease has a large range of feasible etiologies. Prematurity, early and late-onset sepsis and asphyxia are the most usual causes of NT. Moreover, FNAIT is the major risk for intracranial hemorrhage in the fetus or newborn. Here, we reviewed the causes for NT, in both newborns and mothers. We demonstrated the factors associated with NT in the newborn including placental insufficiency, fetal and neonatal alloimmune thrombocytopenia (FNAIT), prematurity, sepsis, and asphyxia. The causes of thrombocytopenia in pregnant women and its impact on newborns were also described. This review showed that gestational thrombocytopenia was the most common cause of thrombocytopenia with an incidence of 70-80%, followed by preeclampsia, HELLP and ITP. But neonates born to mothers with immune thrombocytopenia (ITP) had a higher risk for NT and hemorrhagic problems. In ITP, neonatal platelets are destroyed by maternal autoantibodies. We reviewed the causes of thrombocytopenia in neonates and mothers in two groups of immune and nonimmune factors. However, it seems that immunological factors are the most severe form of NT. However, it is necessary to separate NT etiology for differential diagnosis.
Keywords
Neonatal; Immune Thrombocytopenia; Gestational Thrombocytopenia; Immune; Non-Immune; Etiology
References
1. Rottenstreich A, Israeli N, Levin G, Rottenstreich M, Elchalal U, Kalish Y. Clinical characteristics, neonatal risk and recurrence rate of gestational thrombocytopenia with platelet count< 100× 109/L. Eur J Obstet Gynecol Reprod Biol 2018; 231: 75-9.
2. Liu D, Wu J, Xiong T, Yue Y, Tang J. Platelet transfusion for neonates with thrombocytopaenia: protocol for a systematic review. BMJ Open 2020; 10(10): e039132.
3. Ayadi ID, Hamida EB, Youssef A, Sdiri Y, Marrakchi Z. Prevalence and outcomes of thrombocytopenia in a neonatal intensive care unit. Tunis Med 2016; 94(4): 305-8.
4. Arif H, Ikram N, Riaz S, Nafisa A. Risk factors and outcome of neonatal thrombocytopenia. J Rawalpindi Med Coll 2020; 24(3): 229-234.
5. Gordon P, Christensen R, Weitkamp J-H, Maheshwari A. Mapping the New World of Necrotizing Enterocolitis (NEC): Review and Opinion. EJ Neonatol Res 2012; 2(4): 145-72.
6. Roberts I, Murray NA. Neonatal thrombocytopenia: causes and management. Arch Dis Child Fetal Neonatal Ed 2003; 88(5): F359-64.
7. Ree IMC, Fustolo-Gunnink SF, Bekker V, Fijnvandraat KJ, Steggerda SJ, Lopriore E. Thrombocytopenia in neonatal sepsis: Incidence, severity and risk factors. PLoS One 2017; 12(10): e0185581.
8. K Peterson JA, Mcfarland JG, Curtis BR, Aster RH. Neonatal alloimmune thrombocytopenia: Pathogenesis, diagnosis and management. Br J Haematol 2013; 161(1): 3-14.

9. Wang X, Xu Y, Luo W, Feng H, Luo Y, Wang Y, et al. Thrombocytopenia in pregnancy with different diagnoses. Med (United States) 2017; 96(29): 1-5.
10. Bergmann F, Rath W. Übersichtsarbeit: Differenzialdiagnose der Thrombozytopenie in der Schwangerschaft: Eine interdisziplinäre Herausforderung. Dtsch Arztebl Int 2015; 112(47): 795-802.
11. Melekoğlu NA, Bay A, Aktekin EH, Yilmaz M, Sivasli E. Neonatal outcomes of pregnancy with immune thrombocytopenia. Indian J Hematol Blood Transfus 2017; 33(2): 211-5.
12. Resch E, Hinkas O, Urlesberger B, Resch B. Neonatal thrombocytopenia—causes and outcomes following platelet transfusions. Eur J Pediatr 2018; 177(7): 1045-52.
13. Tirupathi K, Swarnkar K, Vagha J. Study of risk factors of neonatal thrombocytopenia. Int J Contemp Pediatr 2016; 4(1): 191.
14. Jung HE, Shim YR, Oh JE, Oh DS, Lee HK. The autophagy protein Atg5 plays a crucial role in the maintenance and reconstitution ability of hematopoietic stem cells. Immune Netw 2019; 19(2): 1-13.
15. Koltsova EM, Balashova EN, Ignatova AA, Poletaev AV, Polokhov DM, Kuprash AD, et al. Impaired platelet activity and hypercoagulation in healthy term and moderately preterm newborns during the early neonatal period. Pediatr Res 2019; 85(1): 63-71.
16. Stegner D, Vaneeuwijk JMM, Angay O, Gorelashvili MG, Semeniak D, Pinnecker J,et al. Thrombopoiesis is spatially regulated by the bone marrow vasculature. Nat Commun 2017; 8(1): 127.
17. Grozovsky R, Giannini S, Falet H, Hoffmeister KM. Regulating billions of blood platelets: Glycans and beyond. Blood 2015; 126(16): 1877-84.
18. Koltsova EM, Balashova EN, Ignatova AA, Poletaev AV, Polokhov DM, Kuprash AD, et al. Impaired platelet activity and hypercoagulation in healthy term and moderately preterm newborns during the early neonatal period. Pediatr Res 2019; 85(1): 63-71.
19. D’Atri LP, Rodríguez CS, Miguel CP, Pozner RG, Wilczyñski JM, Negrotto S, et al. Activation of toll-like receptors 2 and 4 on CD34+ cells increases human megakaryo/thrombopoiesis induced by thrombopoietin. J Thromb Haemost 2019; 17(12): 2196-210.
20. Levi M. Pathogenesis and diagnosis of disseminated intravascular coagulation. Int J Lab Hematol 2018; 40(Suppl 1): 15-20.
21. Arif SH, Ahmad I, Ali SM, Khan HM. Thrombocytopenia and bacterial sepsis in neonates. Indian J Hematol Blood Transfus 2012; 28(3): 147-51.
22. i Y, Tian Y, Liu N, Chen Y, Wu F. Analysis of 62 placental abruption cases: Risk factors and clinical outcomes. Taiwan J Obstet Gynecol 2019; 58(2): 223-6.
23. Takeda J, Takeda S. Management of disseminated intravascular coagulation associated with placental abruption and measures to improve outcomes. Obstet Gynecol Sci 2019; 62(5): 299-306.
24. Tikkanen M. Placental abruption: Epidemiology, risk factors and consequences. Acta Obstet Gynecol Scand 2011; 90(2): 140-9.
25. Regan F, Lees CC, Jones B, Nicolaides KH, Wimalasundera RC, Mijovic A. Prenatal management of pregnancies at risk of fetal neonatal alloimmune thrombocytopenia (FNAIT): Scientific Impact Paper No. 61. BJOG 2019; 126(10):e173-e185.
26. Tiller H, Husebekk A, Ahlen MT, Stuge TB, Skogen B. Current perspectives on fetal and neonatal alloimmune thrombocytopenia-increasing clinical concerns and new treatment opportunities. Int J Womens Health 2017; 9: 223-34.
27. Baker JM, Shehata N, Bussel J, Murphy MF, Greinacher A, Bakchoul T, et al. Postnatal intervention for the treatment of FNAIT: a systematic review. J Perinatol 2019; 39(10): 1329-39.
28. de Vos TW, Winkelhorst D, de Haas M, Lopriore E, Oepkes D. Epidemiology and management of fetal and neonatal alloimmune thrombocytopenia. Transfus Apher Sci 2020; 59(1): 102704.
29. Winkelhorst D, Oepkes D, Lopriore E. Fetal and neonatal alloimmune thrombocytopenia: evidence based antenatal and postnatal management strategies. Expert Rev Hematol 2017; 10(8): 729-37.
30. Lieberman L, Greinacher A, Murphy MF, Bussel J, Bakchoul T, Corke S, et al. Fetal and neonatal alloimmune thrombocytopenia: recommendations for evidence‐based practice, an international approach. Br J Haematol 2019; 185(3): 549-62.

31. Godara DS, Vyas DL, Narendra D. Prevalence of thrombocytopenia during pregnancy and its effect on pregnancy and neonatal outcome. Sch J Appl Med Sci 2020; 8(2): 681-4.
32. Gaba N, Gaba S. Etiology and fetomaternal outcomes of thrombocytopenia during pregnancy. Perinatology 2020; 21(2): 45-9.
33. Cines DB, Levine LD. Thrombocytopenia in pregnancy. Blood 2017; 130(21): 2271-7.
34. Qureshi AN, Sakina, Taqi T, Khatoon H, Ahmed I. Risk factors and fetomaternal outcome in pregnancy with thrombocytopenia. Prof Med J 2019; 26(11): 1942-6.
35. Brady CW. Liver disease in pregnancy: What’s new. Hepatol Commun 2020; 4(2): 145-56.
36. Christensen RD, Henry E, Wiedmeier SE, Stoddard RA, Sola-Visner MC, Lambert DK, et al. Thrombocytopenia among extremely low birth weight neonates: Data from a multihospital healthcare system. J Perinatol 2006; 26(6): 348-53.
37. Pishko AM, Levine LD, Cines DB. Thrombocytopenia in pregnancy: Diagnosis and approach to management. Blood Rev 2020; 40:100638.
38. Bertrand G, Blouin L, Boehlen F, Levine E, Minon JM, Winer N. Management of neonatal thrombocytopenia in a context of maternal antiplatelet alloimmunization: Expert opinion of the French-speaking working group. Arch Pediatr 2019; 26(3): 191-97.
39. Sillers L, Van Slambrouck C, Lapping-Carr G. Neonatal thrombocytopenia: etiology and diagnosis. Pediatr Ann 2015; 44(7): e175-80.
40. Subtil SFC, Mendes JMB, Areia ALFDA, Moura JPAS. Update on thrombocytopenia in pregnancy. Rev Bras Ginecol Obstet 2020; 42(12): 834-40.
41. Padmawar A, Verma PG, Khadse G, Dhishana SR. Maternal and fetal outcome of pregnancies complicated with thrombocytopenia. Indian J Obstet Gynecol Res 2020; 7(4): 540-3.
42. Silva CL, Grando AC. Complications of idiopathic thrombocytopenic purpura in pregnancy: a review of literature. J Bras Patol Med Lab 2021; 57: 1-8.
43. Arora M, Goyal L, Khutan H. Prevalence of thrombocytopenia during pregnancy & its effect on pregnancy & neonatal outcome. Ann Int Med Dent Res 2017; 3(2): 4-6.
44. Hamad MNM, Idam DK, Alshazali HA. Prevalence of gestational thrombocytopenia among selected group of pregnant women attended to Soba University Hospita. AJRCPS 2017; 5(4): 144-9.
45. Kong Z, Qin P, Xiao S, Zhou H, Li H, Yang R, et al. A novel recombinant human thrombopoietin therapy for the management of immune thrombocytopenia in pregnancy. Blood 2017; 130(9): 1097-103.
46. Davenport PE, Chan Yuen J, Briere J, Feldman HA, Sola-Visner MC, Leeman KT. Implementation of a neonatal platelet transfusion guideline to reduce non-indicated transfusions using a quality improvement framework. J Perinatol 2021, 1-8.
47. Gernsheimer T, James AH, Stasi R. How I treat thrombocytopenia in pregnancy. Blood 2013; 121(1): 38-47.

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