Maternal HPA-1a antibody level and its role in predicting the severity of Fetal/Neonatal Alloimmune Thrombocytopenia : a systematic review
(2019) In Vox Sanguinis 114(1). p.79-94- Abstract
Background and Objectives: In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most commonly due to maternal HPA-1a antibodies. HPA-1a typing followed by screening for anti-HPA-1a antibodies in HPA-1bb women may identify first pregnancies at risk. Our goal was to review results from previous published studies to examine whether the maternal antibody level to HPA-1a could be used to identify high-risk pregnancies. Materials and Methods: The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients. Results: Three prospective studies reported results from screening programmes, and 10 retrospective studies focused on suspected... (More)
Background and Objectives: In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most commonly due to maternal HPA-1a antibodies. HPA-1a typing followed by screening for anti-HPA-1a antibodies in HPA-1bb women may identify first pregnancies at risk. Our goal was to review results from previous published studies to examine whether the maternal antibody level to HPA-1a could be used to identify high-risk pregnancies. Materials and Methods: The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients. Results: Three prospective studies reported results from screening programmes, and 10 retrospective studies focused on suspected cases of FNAIT. In 8 studies samples for antibody measurement, performed by the monoclonal antibody immobilization of platelet antigen (MAIPA) assay, and samples for determining fetal/neonatal platelet count were collected simultaneously. In these 8 studies, the maternal antibody level correlated with the risk of severe thrombocytopenia. The prospective studies reported high negative predictive values (88–95%), which would allow for the use of maternal anti-HPA-1a antibody level as a predictive tool in a screening setting, in order to identify cases at low risk for FNAIT. However, due to low positive predictive values reported in prospective as well as retrospective studies (54–97%), the maternal antibody level is less suited for the final diagnosis and for guiding antenatal treatment. Conclusion: HPA-1a antibody level has the potential to predict the severity of FNAIT.
(Less)
- author
- author collaboration
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- alloimmune thrombocytopenia, bleeding, maternal HPA-1a antibodies, monoclonal antibody immobilization of platelet antigen, platelet
- in
- Vox Sanguinis
- volume
- 114
- issue
- 1
- pages
- 79 - 94
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85058846023
- pmid:30565711
- ISSN
- 0042-9007
- DOI
- 10.1111/vox.12725
- language
- English
- LU publication?
- yes
- id
- f340ac11-2615-4a4d-9e80-5e8dabc7ac57
- date added to LUP
- 2019-01-15 08:14:37
- date last changed
- 2024-05-14 22:38:50
@article{f340ac11-2615-4a4d-9e80-5e8dabc7ac57,
abstract = {{<p>Background and Objectives: In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most commonly due to maternal HPA-1a antibodies. HPA-1a typing followed by screening for anti-HPA-1a antibodies in HPA-1bb women may identify first pregnancies at risk. Our goal was to review results from previous published studies to examine whether the maternal antibody level to HPA-1a could be used to identify high-risk pregnancies. Materials and Methods: The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients. Results: Three prospective studies reported results from screening programmes, and 10 retrospective studies focused on suspected cases of FNAIT. In 8 studies samples for antibody measurement, performed by the monoclonal antibody immobilization of platelet antigen (MAIPA) assay, and samples for determining fetal/neonatal platelet count were collected simultaneously. In these 8 studies, the maternal antibody level correlated with the risk of severe thrombocytopenia. The prospective studies reported high negative predictive values (88–95%), which would allow for the use of maternal anti-HPA-1a antibody level as a predictive tool in a screening setting, in order to identify cases at low risk for FNAIT. However, due to low positive predictive values reported in prospective as well as retrospective studies (54–97%), the maternal antibody level is less suited for the final diagnosis and for guiding antenatal treatment. Conclusion: HPA-1a antibody level has the potential to predict the severity of FNAIT.</p>}},
author = {{Kjær, Mette and Bertrand, Gerald and Bakchoul, Tamam and Massey, Edwin and Baker, Jillian M. and Lieberman, Lani and Tanael, Susano and Greinacher, Andreas and Murphy, Michael F. and Arnold, Donald M. and Baidya, Shoma and Bussel, James and Hume, Heather and Kaplan, Cécile and Oepkes, Dick and Ryan, Greg and Savoia, Helen and Shehata, Nadine and Kjeldsen-Kragh, Jens}},
issn = {{0042-9007}},
keywords = {{alloimmune thrombocytopenia; bleeding; maternal HPA-1a antibodies; monoclonal antibody immobilization of platelet antigen; platelet}},
language = {{eng}},
number = {{1}},
pages = {{79--94}},
publisher = {{Wiley-Blackwell}},
series = {{Vox Sanguinis}},
title = {{Maternal HPA-1a antibody level and its role in predicting the severity of Fetal/Neonatal Alloimmune Thrombocytopenia : a systematic review}},
url = {{http://dx.doi.org/10.1111/vox.12725}},
doi = {{10.1111/vox.12725}},
volume = {{114}},
year = {{2019}},
}