Follow up of children after antenatal treatment for alloimmune thrombocytopenia.

Abstract

OBJECTIVE:

To evaluate the long-term follow-up of surviving offspring after antenatal treatment for fetal or neonatal alloimmune thrombocytopenia (FNAIT).

PATIENTS:

Fifty children at risk of FNAIT were antenatally treated with maternal intravenous immunoglobulins (IVIG) (n=11), IVIG with intrauterine platelet transfusions (IUPT) (n=26) or IUPT alone (n=9). In four cases (n=4), only fetal blood sampling (FBS) was performed. One child died in the neonatal period and one was lost to follow up.

METHODS:

The remaining 48 children, aged 1.3-11.6 years (median 5.1 years), were given both general and neurological examinations and assessed on their development and susceptibility for infections or atopic constitution. In addition, immunoglobulin levels were measured in 17 infants, aged 5 years and older.

RESULTS:

Intracranial hemorrhage (ICH) was not observed. The general health and neurodevelopmental outcome in the children was comparable to a normal Dutch population. Children not exposed to maternal IVIG treatment had significantly more infections and hearing problems than children exposed to IVIG treatment or the normal population. Immunoglobulin G, A and M levels were within the normal range, independent of treatment and severity of FNAIT. A high IgE level was more frequently seen in children exposed to IVIG, but did not result in clinical consequences such as allergy or atopy.

CONCLUSIONS:

Antenatal treatment of children for FNAIT did not affect general health or neurodevelopmental outcome. In particular, exposure to IVIG in utero showed no adverse effect on the clinical outcome of these children.

• Authors: Celine M Radder, Monique J J de Haan, Anneke Brand, Gerlinde M S J Stoelhorst, Sylvia Veen, Humphrey H H Kanhai
• Journal: Early human development (Early Hum Dev) Vol. 80 Issue 1 Pg. 65-76 (Oct 2004) ISSN: 0378-3782 [Print] Ireland
• PMID: 15363839 (Publication Type: Journal Article)

Chemical References

• Immunoglobulins
• Immunoglobulins, Intravenous

Topics

• Blood Transfusion, Intrauterine
• Child
• Child Development (classification)
• Child, Preschool
• Combined Modality Therapy
• Female
• Fetal Diseases (immunology, therapy)
• Follow-Up Studies
• Humans
• Immunoglobulins (blood)
• Immunoglobulins, Intravenous (administration & dosage)
• Infant
• Platelet Transfusion
• Pregnancy
• Purpura, Thrombocytopenic, Idiopathic (therapy)