학술논문

A combined effect of anti-HPA-1a and anti-HLA Class I in pregnancy?
Document Type
Journal Article
Source
Transfusion. Sep2020, Vol. 60 Issue 9, p2121-2129. 9p.
Subject
*Platelet count
*Pregnancy
*Mothers
*Regression analysis
*Thrombocytopenia
*Autoantibodies
*Retrospective studies
*Fetal diseases
*Research funding
*Histocompatibility antigens
*Antigens
Language
ISSN
0041-1132
Abstract
Background: Maternal anti-human leukocyte antigen (HLA) Class I is commonly detected alongside anti-human platelet antigen (HPA)-1a in fetal and neonatal alloimmune thrombocytopenia (FNAIT). Little is known regarding whether the presence of anti-HLA Class I may exert an additive effect on the risk and severity of FNAIT.Methods and Materials: We reanalyzed samples originally collected as part of a large Norwegian screening study on FNAIT during 1995-2004. This study identified and managed 170 pregnancies where the mother was HPA-1a negative and had detectable anti-HPA-1a during pregnancy. Maternal samples from 166 of these pregnancies were rescreened for anti-HLA Class I, revealing 111 (67%) that were antibody positive. Various regression models were used to assess if and how maternal anti-HLA Class I influenced the neonatal platelet count.Results and Conclusions: Unadjusted neonatal platelet counts and the frequency of neonatal thrombocytopenia was not significantly affected by the presence of anti-HLA Class I alongside anti-HPA-1a, but results from regression analyses revealed a possible increased risk when the mother was nulliparous. These results warrant further investigation. [ABSTRACT FROM AUTHOR]