Abstract | BACKGROUND: OBJECTIVE: STUDY DESIGN: An observational cohort study was performed, including children of mothers treated with intravenous immunoglobulin during pregnancy because a previous child was diagnosed with fetal and neonatal alloimmune thrombocytopenia. Children were invited for a follow-up assessment including standardized cognitive and neurologic tests. The parents were asked to complete a behavioral questionnaire and school performance reports. The primary outcome was severe neurodevelopmental impairment, defined as severe cognitive impairment (intelligence quotient <70), cerebral palsy with Gross Motor Function Classification System Level ≥3, bilateral blindness, and/or bilateral deafness (requiring amplification). The secondary outcome was mild to moderate neurodevelopmental impairment, defined as either mild to moderate cognitive impairment (intelligence quotient <85), cerebral palsy with Gross Motor Function Classification System Level ≤2, minor neurologic dysfunction, vision loss, and/or hearing loss. RESULTS: Between 2003 and 2017, 51 children were live-born after antenatal intravenous immunoglobulin treatment. One family moved abroad and was therefore not eligible for inclusion. In total, 82% (41/50) of the eligible cases were included for neurodevelopmental assessment at a median age of 9 years and 8 months. Severe neurodevelopmental impairment was not detected. The incidence of mild to moderate neurodevelopmental impairment was 14% (6/41; 95% confidence interval, 6%-29%). The children's mean cognitive score, behavioral scores, and academic achievement were not different from those observed in the Dutch norm groups. Neuroimaging was performed in 90% (37/41) of cases. Severe intracranial hemorrhage was diagnosed in 2 cases (5%), one antenatally before the start of intravenous immunoglobulin and the other case 1 day after birth. Both cases had a normal neurodevelopmental outcome. CONCLUSION:
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Authors | Thijs W de Vos, Masja de Haas, Dick Oepkes, Ratna N G B Tan, C Ellen van der Schoot, Sylke J Steggerda, Linda S de Vries, Enrico Lopriore, Jeanine M M van Klink |
Journal | American journal of obstetrics and gynecology
(Am J Obstet Gynecol)
Vol. 227
Issue 4
Pg. 637.e1-637.e9
(10 2022)
ISSN: 1097-6868 [Electronic] United States |
PMID | 35671780
(Publication Type: Journal Article, Observational Study)
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Copyright | Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Immunoglobulins, Intravenous
- Isoantibodies
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Topics |
- Cerebral Palsy
- Child
- Female
- Humans
- Immunoglobulins, Intravenous
(therapeutic use)
- Infant, Newborn
- Intracranial Hemorrhages
- Isoantibodies
- Pregnancy
- Thrombocytopenia, Neonatal Alloimmune
(diagnosis, drug therapy)
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