The incidence and outcomes of fetomaternal alloimmune thrombocytopenia: a UK national study using three data sources

Abstract

Summary Fetomaternal alloimmune thrombocytopenia (FMAIT) is the most common cause of severe neonatal thrombocytopenia in otherwise well, term infants. First pregnancies are often severely affected. This descriptive, population‐based national study was undertaken in order to inform the case for antenatal screening. Cases were identified using three sources and capture‐recapture techniques used to generate a robust incidence estimate. One hundred and seventy three cases were identified between October 2006 and September 2008. An extra 20 cases were estimated from capture‐recapture analysis, giving an estimated incidence of clinically detected FMAIT of 12·4 cases per 100 000 total births (95%confidence interval: 10·7, 14·3). Fifty‐two cases (30%) were known at the start of pregnancy; 120 (70%) were unknown (n = 115) or unrecognized (n = 5). Unknown cases were more likely to experience a haemorrhagic complication (67% vs. 5%) (P < 0·001) and more likely to have an intracranial haemorrhage (20% vs. 4%) (P = 0·014) than known cases receiving antenatal management. In view of the incidence of severe disease identified, further assessment of the case for antenatal screening is important. There were a number of cases in which the significance of a history of FMAIT in a previous sibling was not recognized and there is a need to raise awareness of the importance of this diagnosis.

Response: prediction of the fetal status in noninvasive management of alloimmune thrombocytopenia

“…However the severity of clinical presentation and percentage of primigravida in newly diagnosed cases were very similar to previous larger cohort retrospective reports [2][3][4] When biologic markers were analyzed careful consideration was given to (1) gestation range. The alloantibody concentration analysis was reviewed only with the first treated pregnancy of each mother (2) severity of the disease, platelet count Ͻ 50 ϫ 10 9 /L (3) timing of maternal samplings: at delivery means samplings done on delivery and NOT during the postnatal period.…”

Perinatal Outcome and Long-Term Neurodevelopment after Intracranial Haemorrhage due to Fetal and Neonatal Alloimmune Thrombocytopenia

“…Moreover, we were able to do long-term follow-up at a median age of 7.5 years. Previously, follow-up at 1 year had been analysed in newly detected FNAIT cases, with various clinical presentations, by Knight et al [19]. They reported death or disability in 9 out of 88 cases, 2 infants died, 2 infants had severe global developmental delay, 4 infants had motor and visual impairment, and 1 infant had only visual problems.…”

Prevalence of autosomal recessive congenital ichthyosis: A population-based study using the capture-recapture method in Spain

“…6 This modification, based on how much different lists overlap, has been used to describe the prevalence of diseases. [7][8][9][10] We used the technique to obtain an improved estimation of the prevalence of ARCI in Spain.…”