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Fetal/neonatal alloimmune thrombocytopenia : A systematic review of impact of HLA-DRB3∗01:01 on fetal/neonatal outcome

Kjeldsen-Kragh, Jens LU ; Fergusson, Dean A. ; Kjaer, Mette ; Lieberman, Lani ; Greinacher, Andreas ; Murphy, Michael F. ; Bussel, James ; Bakchoul, Tamam ; Corke, Stacy and Bertrand, Gérald , et al. (2020) In Blood Advances 4(14). p.3368-3377
Abstract

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... (More)

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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publishing date
type
Contribution to journal
publication status
published
subject
in
Blood Advances
volume
4
issue
14
pages
10 pages
publisher
American Society of Hematology
external identifiers
  • pmid:32717028
  • scopus:85090446300
ISSN
2473-9529
DOI
10.1182/bloodadvances.2020002137
language
English
LU publication?
yes
id
904217c3-f6c5-40fc-91dd-0b047aa255f6
date added to LUP
2020-10-22 15:01:15
date last changed
2025-01-10 20:15:17
@article{904217c3-f6c5-40fc-91dd-0b047aa255f6,
  abstract     = {{<p>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 &lt; 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-. </p>}},
  author       = {{Kjeldsen-Kragh, Jens and Fergusson, Dean A. and Kjaer, Mette and Lieberman, Lani and Greinacher, Andreas and Murphy, Michael F. and Bussel, James and Bakchoul, Tamam and Corke, Stacy and Bertrand, Gérald and Oepkes, Dick and Baker, Jillian M. and Hume, Heather and Massey, Edwin and Kaplan, Cecile and Arnold, Donald M. and Baidya, Shoma and Ryan, Greg and Savoia, Helen F. and Landry, Denise and Shehata, Nadine}},
  issn         = {{2473-9529}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{14}},
  pages        = {{3368--3377}},
  publisher    = {{American Society of Hematology}},
  series       = {{Blood Advances}},
  title        = {{Fetal/neonatal alloimmune thrombocytopenia : A systematic review of impact of HLA-DRB3∗01:01 on fetal/neonatal outcome}},
  url          = {{http://dx.doi.org/10.1182/bloodadvances.2020002137}},
  doi          = {{10.1182/bloodadvances.2020002137}},
  volume       = {{4}},
  year         = {{2020}},
}