{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T21:45:18Z","timestamp":1787867118555,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,3]],"date-time":"2024-11-03T00:00:00Z","timestamp":1730592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Little scientific evidence exists on maternal and fetal outcomes in aplastic anemia (AA) during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>The review was conducted to assess the maternal and fetal outcomes due to AA during pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>Web of Science, EMBASE, PubMed, Scopus, Cochrane CENTRAL, and registries until May 5, 2024.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Eligibility Criteria<\/jats:title><jats:p>Studies (prospective, retrospective cohort, cross\u2010sectional, one arm, survey, follow\u2010up studies) evaluating AA during pregnancy were searched as per PROSPERO registered protocol (CRD42024506668). Case reports, case series, expert opinion letters, and studies assessing less than or equal to 10 pregnant women were not considered. The primary outcome was the prevalence of preeclampsia in AA pregnancies. The secondary outcomes included spontaneous abortion, preterm premature rupture of membranes, premature rupture of membranes, fetal growth restriction, type of delivery, intrauterine fetal death, maternal and neonatal mortality, and pre and post\u2010pregnancy remission status comparison.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The quality of research was checked using the New Castle\u2010Ottawa risk\u2010of\u2010bias tool. A meta\u2010analysis model with a random effect distribution, coupled with meta\u2010regression, sensitivity analysis, and publication bias assessment, was used in the statistical software R. Standard Equator network study reporting guidelines were followed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seven (one prospective and six retrospective cohort) studies included patients with confirmed AA diagnosis in 248 pregnancies. The pooled prevalence of preeclampsia was 13% (95% CI, 8%\u201320%). Heterogeneity was low in the present meta\u2010analysis (<jats:italic>I<\/jats:italic>\n<jats:sup>\n<jats:italic>2<\/jats:italic>\n<\/jats:sup>\u2009=\u200926%). The secondary outcome evaluation showed a pooled prevalence of 5% (95% CI, 3%\u201311%) for spontaneous abortion, 4% (95% CI, 1%\u201311%) for preterm premature rupture of membranes, 10% (95% CI, 3%\u201328%) for premature rupture of membranes, 6% (95% CI, 3%\u201311%) for fetal growth restriction, 5% (95% CI, 2%\u201313%) for intrauterine fetal death, 12% (95% CI, 5%\u201326%) for post\u2010partum hemorrhage, 74% (95% CI, 45%\u201391%) for intrapartum transfusion requirement, and 55% (95% CI, 27%\u201380%) for the cesarean delivery opting. The maternal mortality in pregnancies with AA was 4% (95% CI, 0.01\u20130.14), whereas neonatal mortality was 7% (95% CI, 0.03\u20130.18). The odds of AA complete remission were better in pre\u2010pregnancy than post\u2010pregnancy (OR\u2009=\u20090.36; 95% CI\u2009=\u20090.08\u20131.66), although the results remain insignificant. The leave\u2010one\u2010out sensitivity analysis did not change the pooled estimates for the primary outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A risk of developing preeclampsia was observed in every eighth pregnant woman with an AA diagnosis. AA remission status might worsen after undergoing pregnancy, considering the significant obstetric morbidity and mortality burden.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.14317","type":"journal-article","created":{"date-parts":[[2024,11,4]],"date-time":"2024-11-04T06:15:43Z","timestamp":1730700943000},"page":"202-212","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Maternal and Fetal Outcomes of Aplastic Anemia During Pregnancy and Delivery: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"114","author":[{"given":"Aashima","family":"Arora","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9495-9789","authenticated-orcid":false,"given":"Arihant","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology and Medical Oncology PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3754-7774","authenticated-orcid":false,"given":"Deepesh","family":"Lad","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology and Medical Oncology PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Drishita","family":"Ganguly","sequence":"additional","affiliation":[{"name":"Department of Bioscience and Biotechnology Banasthali Vidyapeeth  Rajasthan India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Khatri","sequence":"additional","affiliation":[{"name":"Department of Pharmacology PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Aaqib","family":"Shamim","sequence":"additional","affiliation":[{"name":"Department of Pharmacology AIIMS  Jodhpur India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijaya Kumar","family":"Padhi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine and School of Public Health PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8552-2796","authenticated-orcid":false,"given":"Amol N.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Pharmacology PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Malhotra","sequence":"additional","affiliation":[{"name":"Department of Clinical Hematology and Medical Oncology PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanita","family":"Jain","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology PGIMER  Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,3]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2147\/IJWH.S149683"},{"issue":"4","key":"e_1_2_10_3_1","article-title":"Aplastic Anaemia in Pregnancy: A Case\u2010Based Comprehensive Review of the Literature","volume":"16","author":"Perolla A.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cvsm.2015.04.006"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2021.1875816"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjog.2017.08.010"},{"issue":"7","key":"e_1_2_10_7_1","first-page":"1120","article-title":"Aplastic Anemia Associated With Pregnancy: Maternal and Fetal Complications","volume":"29","author":"Bo L.","year":"2016","journal-title":"International Journal of Women's Health"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-137-3-200208060-00008"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.14766"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07842.x"},{"key":"e_1_2_10_11_1","article-title":"Aplastic Anemia Treated With Eltrombopag During Pregnancy","volume":"25","author":"Suminaga Y.","year":"2022","journal-title":"Case Reports in Obstetrics and Gynecology"},{"issue":"3","key":"e_1_2_10_12_1","first-page":"126","article-title":"Successful Treatment of Aplastic Anaemia With Cyclosporine During Pregnancy","volume":"77","author":"Hermans B. 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