Abstract Number: PB1395
Meeting: ISTH 2022 Congress
Theme: Women’s Health » Pregnancy and Pregnancy Complications
Background: Immune thrombocytopenia (ITP) has distinct features in pregnancy, accounting for 1-2/1000 of them
Aims: To compare the proportion of bleeding between pregnant and non-pregnant ITP patients and describe the clinical characteristics and treatment in pregnant ITP patients
Methods: We retrospectively included a cohort of ITP pregnant women who attended a university hospital between 2007-2021. Patients with a diagnosis of ITP in pregnancy or with a relapse in pregnancy were considered. A comparison was performed with a group of consecutive IT non-pregnant women (1:1) of the same age range. A multiple logistic regression model was constructed to evaluate the pregnancy/bleeding relationship.
Results: Thirty-four ITP pregnant patients (38 pregnancies) were analyzed and, 38 non-pregnant women with ITP were as a comparator group. The proportion of patients who bled was significantly lower in the pregnant group. A small proportion presented major bleeding in both groups (Table 1). Pregnant patients had higher platelet counts (at diagnosis and nadir). Fewer pregnant women required treatment for ITP, but the rate of complete response (>100×109/L) was higher in non-pregnant women (table 1).
In the bivariate analysis, a platelet count (nadir) lower than 30 x109/L was associated with a higher risk of bleeding [ORc 18.56(95%CI 5.36- 64.18),p < 0.0001]. In contrast, pregnancy was a protective factor of bleeding [ORc 0.03(95%CI 0.007-0.12),p < 0,001]. In the multivariate analysis, pregnancy persisted as a protective factor regardless of platelet count [ORa 0.04(95%CI 0.01-0.20),p < 0.0001].
In the pregnant group, 47% had a history of ITP. In 21 pregnancies, it was necessary to initiate treatment for ITP. The main indication was a low platelet count with a high risk of bleeding. Corticosteroids were the most common therapy.. Thirty-eight percent of the therapies were indicated in preparation for delivery (Table 2).
Conclusion(s): We observed that ITP pregnant patients had significantly lower hemorrhagic manifestations than non-pregnant patients regardless of platelet count.
To cite this abstract in AMA style:
Chuliber F, Muñoz A, Llera L, Privitera V, Mezzarobba D, Villagra Iturre M, Viñuales E, Arbelbide J, Penchasky D. Pregnancy as a protective factor for bleeding in immune thrombocytopenia regardless of platelet count [abstract]. https://abstracts.isth.org/abstract/pregnancy-as-a-protective-factor-for-bleeding-in-immune-thrombocytopenia-regardless-of-platelet-count/. Accessed March 22, 2024.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/pregnancy-as-a-protective-factor-for-bleeding-in-immune-thrombocytopenia-regardless-of-platelet-count/