Is it time to include screening for neonatal alloimmune thrombocytopenia in the general antenatal health care programme?

Abstract

A comprehensive screening and intervention program aimed to reduce morbidity and mortality of neonatal alloimmune thrombocytopenia (NAIT) has recently been carried out in Norway. HPA 1 typing was performed in 100,448 pregnant women. The HPA 1a negative women were screened for anti-HPA 1a antibodies. In immunized women, delivery was performed by Caesarean section 2-4 weeks prior to term with platelets from HPA 1a negative donors reserved for immediate transfusion in severely thrombocytopenic children. This screening and intervention program seemed to reduce the number of cases of severe NAIT-related complications to approximately one fourth. An accompanying health economic analysis seems to indicate that it is possible to establish an antenatal screening programme for NAIT that is cost effective. The Directorate for Health and Social Affairs is now considering if antenatal screening for NAIT should be included in the general antenatal health care programme in Norway.