{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:44:21Z","timestamp":1787013861331,"version":"build-2736575974"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Maternal alloimmunization against human platelet antigen\u20101a (HPA\u20101a) may lead to severe intracranial hemorrhage (ICH) in the fetus or newborn as a life\u2010threatening complication of fetal neonatal alloimmune thrombocytopenia (FNAIT). Most women who are HPA\u20101a\u2010alloimmunized do not have a fetus\/neonate with ICH. In the absence of predictive tools to identify pregnancies with high risk of ICH outcome, most countries offer weekly antenatal IVIg to all recognized HPA\u20101a\u2010alloimmunized pregnancies. Norwegian FNAIT guidelines are restrictive regarding antenatal IVIg administration and have a long\u2010standing tradition of longitudinal anti\u2010HPA\u20101a antibody measurements when at\u2010risk pregnancies are identified, facilitating exploration of the natural history of alloimmunized pregnancies. We aimed to explore associations between maternal anti\u2010HPA\u20101a antibody levels and risk of fetal\/neonatal ICH in non\u2010IVIg treated HPA\u20101a alloimmunized pregnancies and assess if an antibody level threshold can be useful for identifying pregnancies with increased ICH risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>We compared anti\u2010HPA\u20101a levels both from clinically referred and prospectively identified, non\u2010IVIg treated, HPA\u20101a\u2010immunized pregnancies stratified by previous neonatal FNAIT outcome (ICH or FNAIT without ICH) in Norway 1997\u20132023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Anti\u2010HPA\u20101a levels in pregnancies with ICH outcome were higher (median 29.6\u2009IU\/mL, range 0.1\u2013222.1,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915) compared to no ICH FNAIT pregnancies (median 10.4\u2009IU\/mL, range 0.0\u201383.1,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.046, Mann\u2013Whitney\n                      <jats:italic>U<\/jats:italic>\n                      test). A suggestive anti\u2010HPA\u20101a threshold of 70\u2009IU\/mL was chosen based on receiver operating characteristic (ROC) analysis, with high specificity values (96.4%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Antenatal anti\u2010HPA\u20101a levels may be useful when assessing the risk of ICH outcome and may enable a more targeted antenatal IVIg treatment both in a nonscreening and screening situation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70031","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T16:41:17Z","timestamp":1755708077000},"page":"1859-1868","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Improving prediction of fetal\/neonatal intracranial hemorrhage in\n                    <scp>HPA<\/scp>\n                    \u20101a alloimmunized pregnancies to guide antenatal management: An observational cohort study"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9515-0922","authenticated-orcid":false,"given":"Siw Leiknes","family":"Ernstsen","sequence":"first","affiliation":[{"name":"Norwegian National Unit for Platelet Immunology, University Hospital of North Norway, Department of Laboratory Medicine, Division of Diagnostics University Hospital of North Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Therese","family":"Ahlen","sequence":"additional","affiliation":[{"name":"Norwegian National Unit for Platelet Immunology, University Hospital of North Norway, Department of Laboratory Medicine, Division of Diagnostics University Hospital of North Norway  Troms\u00f8 Norway"},{"name":"Immunology Research Group, Department of Medical Biology UiT The Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eirin Listau","family":"Bertelsen","sequence":"additional","affiliation":[{"name":"Immunology Research Group, Department of Medical Biology UiT The Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2901-242X","authenticated-orcid":false,"given":"Jens","family":"Kjeldsen\u2010Kragh","sequence":"additional","affiliation":[{"name":"Norwegian National Unit for Platelet Immunology, University Hospital of North Norway, Department of Laboratory Medicine, Division of Diagnostics University Hospital of North Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Husebekk","sequence":"additional","affiliation":[{"name":"Immunology Research Group, Department of Medical Biology UiT The Arctic University of Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3250-0750","authenticated-orcid":false,"given":"Heidi","family":"Tiller","sequence":"additional","affiliation":[{"name":"Women's Health and Perinatology Research Group, Department of Clinical Medicine UiT The Arctic University of Norway  Troms\u00f8 Norway"},{"name":"Department of Obstetrics and Gynecology University Hospital of North Norway  Troms\u00f8 Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/tropej\/45.4.237"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002490"},{"key":"e_1_2_14_4_1","first-page":"1","article-title":"Perinatal outcome and long\u2010term neurodevelopment after intracranial Haemorrhage due to fetal and neonatal alloimmune 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