{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T23:08:56Z","timestamp":1780096136820,"version":"3.54.0"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000014","name":"Canadian Blood Services","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000014","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013873","name":"Government of Ontario","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013873","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000008","name":"Health Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000008","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is the most common cause of intracranial hemorrhage (ICH) in thrombocytopenic term infants. We investigated clinical and laboratory predictors of severe FNAIT in a tertiary care referral center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>Retrospective cohort study over a 30\u2010year period. We defined FNAIT as recurrence of neonatal thrombocytopenia in a subsequent pregnancy; and severe outcomes as any of: (1) a birth platelet count below 20\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L; (2) ICH or (3) fetal death. We used a generalized estimating equations analysis and classification tree analysis to identify risk factors for severe FNAIT in a subsequent pregnancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During index pregnancies (<jats:italic>n<\/jats:italic>\u00a0=\u00a0135 in 131 mothers), 71 infants (52.6%) had severe outcomes including a platelet count &lt;20\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L (<jats:italic>n<\/jats:italic>\u00a0=\u00a045), fetal or neonatal ICH (<jats:italic>n<\/jats:italic>\u00a0=\u00a032), or fetal death (<jats:italic>n<\/jats:italic>\u00a0=\u00a04). During subsequent pregnancies (<jats:italic>n<\/jats:italic>\u00a0=\u00a072), 15 infants (20.8%) had severe outcomes including birth platelets &lt;20\u2009\u00d7\u200910<jats:sup>9<\/jats:sup>\/L (<jats:italic>n<\/jats:italic>\u00a0=\u00a010), ICH (<jats:italic>n<\/jats:italic>\u00a0=\u00a02), or death (<jats:italic>n<\/jats:italic>\u00a0=\u00a03). Forty\u2010two women (58.3%) received antenatal intravenous immune globulin (IVIG) during subsequent pregnancies. Eight mothers (<jats:italic>n<\/jats:italic>\u00a0=\u00a09 infants) had severe FNAIT outcomes despite receiving antenatal IVIG. Maternal antibodies to human platelet antigens (HPA) was the only independent predictor of severe FNAIT in a subsequent pregnancy (OR\u00a0=\u00a025.3, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.004). Nevertheless, one of 43 infants from antibody\u2010negative mothers had a severe outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The presence of anti\u2010HPA is highly indicative of the diagnosis of severe FNAIT; however, we observed one infant who had severe FNAIT recurrence, defined using strict clinical criteria, without a maternal antibody. Improved diagnostic and therapeutic strategies are needed to prevent severe FNAIT in high\u2010risk mothers.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.17144","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T08:21:13Z","timestamp":1665735673000},"page":"2213-2222","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical and laboratory predictors of fetal and neonatal alloimmune thrombocytopenia"],"prefix":"10.1111","volume":"62","author":[{"given":"Kristine","family":"Matusiak","sequence":"first","affiliation":[{"name":"Department of Medicine University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher J.","family":"Patriquin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Medical Oncology &amp; Hematology University Health Network, University of Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy","family":"Deniz","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"McMaster Centre for Transfusion Research, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Dzaja","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"McMaster Centre for Transfusion Research, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James W.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Wang","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishac","family":"Nazy","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John G.","family":"Kelton","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"},{"name":"Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine McMaster University  Hamilton Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0943-8853","authenticated-orcid":false,"given":"Donald M.","family":"Arnold","sequence":"additional","affiliation":[{"name":"McMaster Centre for Transfusion Research, Michael G. 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