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. 2012:2012:156867.
doi: 10.1155/2012/156867. Epub 2011 Nov 2.

The development of severe neonatal alloimmune thrombocytopenia due to anti-HPA-1a antibodies is correlated to maternal ABO genotypes

Maria Therese Ahlen  1 , Anne Husebekk, Mette Kjær Killie, Jens Kjeldsen-Kragh, Martin L Olsson, Bjørn Skogen
Affiliations

The development of severe neonatal alloimmune thrombocytopenia due to anti-HPA-1a antibodies is correlated to maternal ABO genotypes

Maria Therese Ahlen et al. Clin Dev Immunol. 2012.

Abstract

Background: Maternal alloantibodies against HPA-1a can cross placenta, opsonize foetal platelets, and induce neonatal alloimmune thrombocytopenia (NAIT). In a study of 100, 448 pregnant women in Norway during 1995-2004, 10.6% of HPA-1a negative women had detectable anti-HPA-1a antibodies.

Design and methods: A possible correlation between the maternal ABO blood group phenotype, or underlying genotype, and severe thrombocytopenia in the newborn was investigated.

Results: We observed that immunized women with blood group O had a lower risk of having a child with severe NAIT than women with group A; 20% with blood group O gave birth to children with severe NAIT, compared to 47% among the blood group A mothers (relative risk 0.43; 95% CI 0.25-0.75).

Conclusion: The risk of severe neonatal alloimmune thrombocytopenia due to anti-HPA-1a antibodies is correlated to maternal ABO types, and this study indicates that the observation is due to genetic properties on the maternal side.

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Figures

Figure 1
Figure 1
The platelet count at delivery in HPA-1a-positive newborns was grouped according to maternal ABO type (A or O). Platelet count ≤150 × 109/L (dashed line) is defined as NAIT and <50 × 109/L (dotted line) as severe NAIT. The mean platelet counts in the three groups are indicated, with error bars representing 95% CI. Mean platelet counts are significantly different (P < 0.019, one-way ANOVA). The mean antibody levels between these groups are not significantly different: 11.6 IU/mL for blood group A mothers, 11.1 IU/mL for O02-positive blood group O mothers, and 1.8 IU/mL O02-negative blood group O mothers.
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