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Pregnancy and Birth Outcomes among Women with Idiopathic Thrombocytopenic Purpura


Affiliations
1 Pregistry, Los Angeles, CA 90045, United States
2 Epidemiology, Optum Insight, Waltham, MA 02451, United States
3 Children’s Hospital Boston, Boston, MA 02115, United States
4 Medical Genetics Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
5 Palo Alto Medical Foundation, Mountain View, CA 94040, United States
6 Department of Pediatrics, Division of Genetics, University of California, San Francisco, San Francisco, CA 94115, United States
7 College of Public Health, University of South Florida, Tampa, FL 33612, United States
 

Objective: To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP) or chronic ITP (cITP) diagnosed before or during pregnancy. Methods: A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, andmajor congenital anomalies. Results: Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery.Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live births were preterm. Conclusions: The results of this study provide further evidence that cause and duration of maternal ITP are important determinants of the outcomes of pregnancy.
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  • Pregnancy and Birth Outcomes among Women with Idiopathic Thrombocytopenic Purpura

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Authors

Diego F. Wyszynski
Pregistry, Los Angeles, CA 90045, United States
Wendy J. Carman
Epidemiology, Optum Insight, Waltham, MA 02451, United States
Alan B. Cantor
Children’s Hospital Boston, Boston, MA 02115, United States
John M. Graham
Medical Genetics Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, United States
Liza H. Kunz
Palo Alto Medical Foundation, Mountain View, CA 94040, United States
Anne M. Slavotinek
Department of Pediatrics, Division of Genetics, University of California, San Francisco, San Francisco, CA 94115, United States
Russell S. Kirby
College of Public Health, University of South Florida, Tampa, FL 33612, United States
John Seeger
Epidemiology, Optum Insight, Waltham, MA 02451, United States

Abstract


Objective: To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP) or chronic ITP (cITP) diagnosed before or during pregnancy. Methods: A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, andmajor congenital anomalies. Results: Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery.Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live births were preterm. Conclusions: The results of this study provide further evidence that cause and duration of maternal ITP are important determinants of the outcomes of pregnancy.