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

Research output: Contribution to journalReview article

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 (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-.

Details

Authors
  • Jens Kjeldsen-Kragh
  • Dean A. Fergusson
  • Mette Kjaer
  • Lani Lieberman
  • Andreas Greinacher
  • Michael F. Murphy
  • James Bussel
  • Tamam Bakchoul
  • Stacy Corke
  • Gérald Bertrand
  • Dick Oepkes
  • Jillian M. Baker
  • Heather Hume
  • Edwin Massey
  • Cecile Kaplan
  • Donald M. Arnold
  • Shoma Baidya
  • Greg Ryan
  • Helen F. Savoia
  • Denise Landry
  • And 1 others
  • Nadine Shehata
Organisations
External organisations
  • University Hospital of North Norway
  • Ottawa Hospital Research Institute
  • University of Ottawa
  • Finnmark Hospital Trust
  • UiT The Arctic University of Norway, Tromsø
  • University Health Network University of Toronto
  • University of Toronto
  • University Medicine Greifswald
  • Oxford University Hospitals NHS Foundation Trust
  • University of Oxford
  • New York Presbyterian Hospital/Columbia University Medical Center
  • University of Tübingen
  • Naitbabies
  • French Blood Services of Brittany
  • Leiden University Medical Centre
  • Hospital for Sick Children, Toronto
  • Saint Michael's Hospital
  • McMaster University
  • Australian Red Cross
  • Mount Sinai Hospital of University of Toronto
  • Royal Children's Hospital, Melbourne
  • Canadian Blood Services
  • National Health Service Blood and Transplant
  • International Blood Group Reference Laboratory
  • Centre Hospitalier Universitaire Sainte-Justine
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology
Original languageEnglish
Pages (from-to)3368-3377
Number of pages10
JournalBlood Advances
Volume4
Issue number14
Publication statusPublished - 2020 Jul 28
Publication categoryResearch
Peer-reviewedYes