Neonatal Thrombocytopenia as a Consequence of Maternal Preeclampsia

Abstract

Am J Perinatol Rep 2016;6:e42–e47. Preeclampsia Preeclampsia (preE) is a clinical disorder that affects 3 to 10% of pregnancies in the United States and is a major cause of fetal and maternal morbidity and mortality. PreE causes about 60,000 maternal deaths per year worldwide. 1 It is characterized by the de novo development of hypertension and proteinuria in pregnant women and is often accompa-nied by edema, neurological complications, and intrauterine growth restriction (IUGR). Diagnosis of preE includes a sys-tolic blood pressure (BP) of 140 mm Hg or higher or a diastolic BP of 90 mm Hg or higher along with proteinuria of 0.3 g or more in a 24-hour urine specimen. This typically begins after 20 weeks of gestation and can eventually lead to premature delivery and poses additional risk to the mother and baby. Attempts of early diagnosis and treatment have been unsuc-cessful so far. However, various risk factors have been identi-fied that increase the mother's chances of developing preE during pregnancy. These include, among others, nulliparity, obesity (body mass index > 35 kg/m 2), a pregnancy interval of more than 10 years, history of preE or gestational diabetes, preexisting hypertension, multiple pregnancies, maternal Keywords ► preeclampsia ► neonatal thrombocytopenia ► pregnancy-induced hypertension Abstract Introduction Preeclampsia (preE) is pregnancy-induced hypertension affecting a significant proportion of pregnant women worldwide and can cause detrimental effects in the mother and newborn. Some of the effects in the newborn include neonatal thrombocytopenia. Pertaining specifically to neonatal thrombocytopenia, several questions remain unanswered. Discussion According to the current literature, neonatal thrombocytopenia due to maternal preE is highly prevalent in the general population and the incidence is reported to be around 30% worldwide. This review gives an insight into the syndrome and summarizes the possible pathological mechanisms, the diagnostic approach, compli-cations, and therapeutic interventions of neonatal thrombocytopenia. It also identifies the involvement of other cell lines, apart from platelets in the newborns. Furthermore, we suggest a future prospective study to investigate the pathogenesis of preE and plan a study involving animal models to come up with a possible therapeutic intervention to prevent preE and its various consequences in neonates.