原发免疫性血小板减少症孕妇新生儿发生血小板减少症相关因素分析  

Correlation factor analysis of neonatal thrombocytopenia in pregnant women with primary immune thrombocytopenic purpura

作　　者：黄琼辉 邢丽莉[2] 刘捷[1] 曾超美[1] 严荔煌[2] HUANG Qionghui;XING Lili;LlUJie;ZENG Chaomei;YAN Lihuang(Department of Obsterics and Gynecology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院儿科,100044 [2]北京大学人民医院妇产科,100044

出　　处：《中国妇产科临床杂志》2022年第4期382-385,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：北京市临床重点专科项目(2199000726)。

摘　　要：目的探讨原发免疫性血小板减少症(primary immune thrombocytopenia,ITP)孕妇所生新生儿的结局,并预测新生儿血小板减少症(neonatal thrombocytopenia,NT)发生的风险因素。方法回顾性分析本院产科2015年10月至2020年12月ITP产妇105例及其新生儿111例。结果111例新生儿中,41例(36.9%)发生NT(血小板计数<150×10^(9)/L),其中21例(51.2%)血小板计数低于50×10^(9)/L,但均未发生严重出血及不良预后。NT组新生儿母亲妊娠前和妊娠期最低血小板计数较非NT组低;但产时母亲血小板计数及ITP病史年限无明显差异(P<0.05)。既往有NT分娩史对此次妊娠可能发生NT有较高预测价值(OR=8.070,95%CI:1.686~38.633)。结论妊娠合并ITP出现NT发生率高,但新生儿不良结局发生率低。NT的发生可能与ITP孕妇妊娠前和妊娠期最低血小板计数有关;既往有NT分娩史是预测本次分娩新生儿再次发生NT的危险因素。Objective To investigate the maternal and neonatal outcomes of pregnancies with primary immune thrombocytopenia(ITP)and also to identify risk factors that predicts neonatal-thrombocytopenia(NT).Methods This retrospective study was performed in a single academic center from October 2015 to December 2020.Pregnant women with ITP and their babies were included.Medical records of 111 neonates born from 105 mothers were analyzed.Results A total of 41(36.9%)of neonates were thrombocytopenic(<150×10^(9)/L)and in 21(51.2%)platelet count was below 50×10^(9)/L,but none of them presented with severe bleeding.The lowest platelet count before and during pregnancy in NT group was lower than control group.However,there was no significant difference in maternal platelet count at the time of delivery and ITP history.Previous delivery history of NT had high predictive value for the possible occurrence of NT in this pregnancy(OR=8.070,95%CI:1.686~38.633).Conclusion Neonates born to mothers with ITP have an increased tendency to develop thrombocytopenia,but the incidence of poor neonatal outcomes is extremely low.The occurrence of NT may be associated with the lowest platelet count before and during pregnancy in ITP pregnant women.The presence of an older sibling with neonatal thrombocytopenia may be a risk factor for neonatal thrombocytopenia in subsequent pregnancies.

关 键 词：妊娠 原发免疫性血小板减少 新生儿 新生儿血小板减少症 

分 类 号：R714.254[医药卫生—妇产科学]