Association of Severe Thrombocytopenia and Poor Prognosis in Pregnancies with Aplastic Anemia

作者：Shin Jae Eun; Lee Young; Kim Sa Jin; Shin Jong Chul^*

来源：PLos One, 2014, 9(7): e103066.

DOI：10.1371/journal.pone.0103066

Purpose: We sought to estimate the risks of adverse obstetric outcomes and disease outcomes associated with severe thrombocytopenia in pregnant women with aplastic anemia (AA). %26lt;br%26gt;Methods: In a retrospective study, we compared demographics, clinical characteristics, laboratory results, and outcomes between severe thrombocytopenia (ST) and non-severe thrombocytopenia (non-ST) groups comprising pregnant women with AA. %26lt;br%26gt;Results: Of 61 AA patients, 43 (70%) were diagnosed as AA before pregnancy and 18 (30%) were AA during pregnancy. The ST group exhibited lower gestational age at nadir of platelet count (26.0 versus 37.0 weeks, p%26lt;0.001) and at delivery (37.3 versus 39.1 weeks, p = 0.008), and a higher rate of bleeding gums (33.8 versus 7.7%, p = 0.015) than the non-ST group. In addition, the ST group exhibited more transfusions during pregnancy (72.7 versus 15.4%, p%26lt;0.001) and postpartum period (45.0 versus 2.7%, p%26lt;0.001), and more bone marrow transplant after delivery (25.0 versus 0.0%, p%26lt;0.001) than the non-ST group. The ST group had a higher odds ratio of composite disease complications (OR, 9.63; 95% CI, 2.82-32.9; p%26lt;0.001) and composite obstetric complications (OR, 6.78; 95% CI, 2.11-21.8; p = 0.001) than the non-ST group. %26lt;br%26gt;Conclusions: Severe thrombocytopenia is more associated with obstetric and disease complications than is non-severe thrombocytopenia in pregnant women with AA.

• 出版日期2014-7-24