Title :

Immune thrombocytopenia and pregnancy: an exposed/non-exposed cohort study.

Author(s) :

Guillet, Stéphanie [Auteur]
Hôpital Henri Mondor
Boutin, Emmanuelle [Auteur]
IMRB - CEPIA/"Clinical Epidemiology And Ageing : Geriatrics, Primary Care and Public Health" [Créteil] [U955 Inserm - UPEC]
Zarour, Anissa [Auteur]
Institut Mondor de Recherche Biomédicale [IMRB]
Comont, Thibault [Auteur]
Institut Universitaire du Cancer de Toulouse - Oncopole [IUCT Oncopole - UMR 1037]
Souchaud-Debouverie, Odile [Auteur]
Centre hospitalier universitaire de Poitiers = Poitiers University Hospital [CHU de Poitiers [La Milétrie]]
Costedoat, Nathalie [Auteur]
Service de médecine interne et centre de référence des maladies rares [CHU Cochin]
Pan-Petesch, Brigitte [Auteur]
Université de Brest [UBO]
Gobert, Delphine [Auteur]
CHU Saint-Antoine [AP-HP]
Cheze, Stéphane [Auteur]
CHU Caen
Viallard, Jean François [Auteur]
Hôpital Haut-Lévêque [CHU Bordeaux]
Morin, Anne-Sophie [Auteur]
Hôpital Jean Verdier [AP-HP]
Sauvetre, Gaetan [Auteur]
Service de Médecine Interne [CHU Rouen]
Cliquennois, Manuel [Auteur]
Groupe Hospitalier de l'Institut Catholique de Lille [GHICL]
Royer, Bruno [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
CHU Amiens-Picardie
Masseau, Agathe [Auteur]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Terriou, Louis [Auteur]
Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286
Fieschi, Claire [Auteur]
Hopital Saint-Louis [AP-HP] [AP-HP]
Lambotte, Olivier [Auteur]
Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
Girault, Stephane [Auteur]
CHU Limoges
Lioger, Bertrand [Auteur]
Centre Hospitalier de Blois [CHB]
Audia, Sylvain [Auteur]
CHU Dijon
Sacre, Karim [Auteur]
Centre de recherche sur l'Inflammation [CRI (UMR_S_1149 / ERL_8252 / U1149)]
Lega, Jean-Christophe [Auteur]
Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 [LBBE]
Langlois, Vincent [Auteur]
Groupe Hospitalier du Havre Hôpital Jacques Monod (MONTIVILLIERS) [GHH]
Benachi, Alexandra [Auteur]
Université Paris-Saclay
Orvain, Corentin [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Devidas, Alain [Auteur]
Centre Hospitalier Sud Francilien
Humbert, Sebastien [Auteur]
Centre Hospitalier Régional Universitaire de Besançon [CHRU Besançon]
Gambier, Nicolas [Auteur]
Ruivard, Marc [Auteur]
CHU Clermont-Ferrand
Zarrouk, Virginie [Auteur]
Hôpital Beaujon [AP-HP]
Ebbo, Mikael [Auteur]
Hôpital de la Conception [CHU - APHM] [LA CONCEPTION]
Willems, Lise [Auteur]
Hôpital Cochin [AP-HP]
Segaux, Lauriane [Auteur]
Hôpital Henri Mondor
Mahevas, Matthieu [Auteur]
Hôpital Henri Mondor
Haddad, Bassam [Auteur]
Institut Mondor de Recherche Biomédicale [IMRB]
IMRB - I-BIOT/"Immunorégulation et Biothérapie" [Créteil] [U955 Inserm - UPEC]
Michel, Marc [Auteur]
Hôpital Henri Mondor
Canoui-Poitrine, Florence [Auteur]
Godeau, Bertrand [Auteur]

Journal title :

Blood

Abbreviated title :

Blood

Volume number :

141

Pages :

11–21

Publication date :

2022-09-11

ISSN :

1528-0020

English keyword(s) :

Clinical Trials and Observations
Platelets and Thrombopoiesis
Plenary Papers
Thrombocytopenia

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

The risk of immune thrombocytopenia (ITP) worsening during pregnancy and neonatal ITP (NITP) have never been prospectively studied. We included 180 pregnant and 168 nonpregnant women with ITP in a prospective, multicenter, ...
Show more >The risk of immune thrombocytopenia (ITP) worsening during pregnancy and neonatal ITP (NITP) have never been prospectively studied. We included 180 pregnant and 168 nonpregnant women with ITP in a prospective, multicenter, observational cohort study. A total of 131 pregnant women with ITP were matched to 131 nonpregnant women with ITP by history of splenectomy, ITP status (no response, response, complete response), and duration. Groups were followed for 15 months. The primary outcome was the first occurrence of ITP worsening defined by a composite end point including bleeding events and/or severe thrombocytopenia (<30 × 109/L) and/or ITP treatment modification. We also studied the recurrence of ITP worsening and the incidence of NITP and risk factors. The first occurrence of ITP worsening did not differ between pregnant and nonpregnant women with ITP (53.4 per 100 person-years [95% confidence interval {CI}, 40.8-69.9] vs 37.1 [95% CI, 27.5-50.0]; hazard ratio {HR}, 1.35 [95% CI, 0.89-2.03], P = .16). Pregnant women with ITP were more likely to have recurrence of severe thrombocytopenia and treatment modification (HR, 2.71 [95% CI, 1.41-5.23], P = .003; HR, 2.01 [95% CI, 1.14-3.57], P = .017, respectively). However, recurrence of severe bleeding events was not different between groups (P = .4). Nineteen (14%) neonates showed NITP <50 × 109/L. By multivariable analysis, NITP was associated with a previous offspring with NITP and maternal platelet count <50 × 109/L within 3 months before delivery (adjusted odds ratio, 5.55 [95% CI, 1.72-17.89], P = .004 and 4.07 [95% CI, 1.41-11.73], P = .009). To conclude, women with ITP do not increase their risk of severe bleeding during pregnancy. NITP is associated with NITP history and the severity of maternal ITP during pregnancy. These results will be useful for counseling women with ITP.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Université de Lille
Inserm
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Submission date :

2024-01-12T00:42:06Z
2024-03-29T07:55:40Z