Fetal/neonatal alloimmune thrombocytopenia: a systematic review of impact of HLA-DRB3*01:01 on fetal/neonatal outcome
AuthorKjeldsen-Kragh, J; Fergusson, DA; Kjaer, M; Lieberman, L; Greinacher, A; Murphy, MF; Bussel, J; Bakchoul, T; Corke, S; Bertrand, G; ...
Source TitleBlood Advances
PublisherAMER SOC HEMATOLOGY
University of Melbourne Author/sSavoia, Helen
Document TypeJournal Article
CitationsKjeldsen-Kragh, J., Fergusson, D. A., Kjaer, M., Lieberman, L., Greinacher, A., Murphy, M. F., Bussel, J., Bakchoul, T., Corke, S., Bertrand, G., Oepkes, D., Baker, J. M., Hume, H., Massey, E., Kaplan, C., Arnold, D. M., Baidya, S., Ryan, G., Savoia, H. F. ,... Shehata, N. (2020). Fetal/neonatal alloimmune thrombocytopenia: a systematic review of impact of HLA-DRB3*01:01 on fetal/neonatal outcome. BLOOD ADVANCES, 4 (14), pp.3368-3377. https://doi.org/10.1182/bloodadvances.2020002137.
Access StatusAccess this item via the Open Access location
Open Access URLhttp://doi.org/10.1182/bloodadvances.2020002137
The most common, severe cases of fetal and neonatal alloimmune thrombocytopenia among whites are caused by antibodies against human platelet antigen 1a (HPA-1a). The aims of this systematic review and meta-analysis are to determine the association between maternal HLA-DRB3*01:01 and: (1) HPA-1a-alloimmunization and (2) neonatal outcome in children born of HPA-1a-immunized women. A systematic literature search identified 4 prospective and 8 retrospective studies. Data were combined across studies to estimate pooled odds ratios (ORs) and the associated 95% confidence intervals (CIs). The population represented by the prospective studies was more than 150 000. In the prospective studies, there were 64 severely thrombocytopenic newborns (platelet count <50 × 109/L) of whom 3 had intracranial hemorrhage. The mothers of all 64 children were HLA-DRB3*01:01+. The number of severely thrombocytopenic children born of HPA-1a-alloimmunized women in the retrospective studies was 214; 205 of whom were born of HLA-DRB3*01:01+ women. For HLA-DRB3*01:01- women, the OR (95% CI) for alloimmunization was 0.05 (0.00-0.60), and for severe neonatal thrombocytopenia 0.08 (0.02-0.37). This meta-analysis demonstrates that the risk of alloimmunization and of having a child with severe thrombocytopenia are both very low for HPA-1a- women who are HLA-DRB3*01:01-.
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