Heidi Tiller1, Mette Kjaer Killie1, Anne Husebekk1,2, Bjørn Skogen1,2, Heyu Ni3,4, Jens Kjeldsen-Kragh5,6, Pål Øian7,8. 1. Laboratory Medicine. 2. Division of Immunology, Institute of Medical Biology. 3. Division of Transfusion Medicine, St. Michael's Hospital, Toronto, Canada. 4. Canadian Blood Services and Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada. 5. Immunology and Transfusion Medicine, Oslo University Hospital, Oslo, Norway. 6. Institute of Clinical Medicine, University of Oslo, Oslo, Norway. 7. Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway. 8. Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Abstract
OBJECTIVE: To assess whether maternal HPA 1a alloimmunization is associated with birthweight. DESIGN: A retrospective observational cohort study. SETTING: The national reference laboratory for clinical platelet immunology at a university hospital. POPULATION: 165 HPA 1a incompatible pregnancies identified from a recent screening study of 100 448 women (124 pregnancies) and the national reference laboratory for clinical platelet immunology (41 pregnancies). METHODS: A linear mixed model analysis was used to assess whether maternal anti-HPA 1a antibodies were associated with birthweight. A generalized linear model was used to assess maternal anti-HPA 1a antibodies as risk factor for small-for-gestational age neonates. Both models were adjusted for gestational age at time of delivery, maternal age, parity, smoking habits during pregnancy, preeclampsia, diabetes mellitus and fetal sex. MAIN OUTCOME MEASURES. Maternal anti-HPA 1a antibody as risk factor of reduced birthweight and small-for-gestational age neonates. RESULTS: The level of maternal anti-HPA 1a antibodies was significantly associated with birthweight and risk of small-for-gestational age neonates after correcting for confounding variables (p<0.001). However, this association was only significant for boys. When the mother had high levels of anti-HPA 1a antibodies during pregnancy, the adjusted mean birthweight in boys was 530g lower compared with anti-HPA 1a antibody negative pregnancies (p<0.001). CONCLUSIONS: A linear relation between maternal anti-HPA 1a antibody levels and reduced birthweight in boys was demonstrated. Reduced birthweight should be considered a possible complication of fetal and neonatal alloimmune thrombocytopenia.
OBJECTIVE: To assess whether maternal HPA 1a alloimmunization is associated with birthweight. DESIGN: A retrospective observational cohort study. SETTING: The national reference laboratory for clinical platelet immunology at a university hospital. POPULATION: 165 HPA 1a incompatible pregnancies identified from a recent screening study of 100 448 women (124 pregnancies) and the national reference laboratory for clinical platelet immunology (41 pregnancies). METHODS: A linear mixed model analysis was used to assess whether maternal anti-HPA 1a antibodies were associated with birthweight. A generalized linear model was used to assess maternal anti-HPA 1a antibodies as risk factor for small-for-gestational age neonates. Both models were adjusted for gestational age at time of delivery, maternal age, parity, smoking habits during pregnancy, preeclampsia, diabetes mellitus and fetal sex. MAIN OUTCOME MEASURES. Maternal anti-HPA 1a antibody as risk factor of reduced birthweight and small-for-gestational age neonates. RESULTS: The level of maternal anti-HPA 1a antibodies was significantly associated with birthweight and risk of small-for-gestational age neonates after correcting for confounding variables (p<0.001). However, this association was only significant for boys. When the mother had high levels of anti-HPA 1a antibodies during pregnancy, the adjusted mean birthweight in boys was 530g lower compared with anti-HPA 1a antibody negative pregnancies (p<0.001). CONCLUSIONS: A linear relation between maternal anti-HPA 1a antibody levels and reduced birthweight in boys was demonstrated. Reduced birthweight should be considered a possible complication of fetal and neonatal alloimmune thrombocytopenia.
Authors: Marije M Kamphuis; Heidi Tiller; E S van den Akker; Magnus Westgren; Eleonor Tiblad; Dick Oepkes Journal: Fetal Diagn Ther Date: 2016-10-12 Impact factor: 2.587
Authors: Heidi Tiller; Marije M Kamphuis; Olof Flodmark; Nikos Papadogiannakis; Anna L David; Susanna Sainio; Sinikka Koskinen; Kaija Javela; Agneta Taune Wikman; Riitta Kekomaki; Humphrey H H Kanhai; Dick Oepkes; Anne Husebekk; Magnus Westgren Journal: BMJ Open Date: 2013-03-22 Impact factor: 2.692