{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T07:17:54Z","timestamp":1776323874578,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T00:00:00Z","timestamp":1759795200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R00HL172303"],"award-info":[{"award-number":["R00HL172303"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2025,12]]},"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Pregnancy is a known trigger for thrombotic thrombocytopenia purpura (TTP); however, there is limited data on the impact of a TTP diagnosis on pregnancy outcomes.<\/jats:p>\n <\/jats:sec>\n \n Study design<\/jats:title>\n We used retrospective data from the National Inpatient Sample database to identify all hospital admissions of pregnant patients (\u226518\u2009years), with and without TTP from 2012 to 2021 using ICD\u20109\/10 codes. To describe the impact of TTP on maternal and fetal morbidity, we identified different morbidity indicators using standard CDC definitions.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n We identified 7,397,411 pregnancy hospitalizations with a mean age of 29\u2009years. Of these, 233 had\n TTP<\/jats:styled-content>\n , with 73 receiving therapeutic plasma exchange (\n TPE<\/jats:styled-content>\n ) during admission, which was treated as a surrogate for active\n TTP<\/jats:styled-content>\n . Severe maternal morbidity rates were several\u2010fold higher in women with\n TTP<\/jats:styled-content>\n (133 per 100 admissions; 95%\n CI<\/jats:styled-content>\n 112\u2013155) compared to those without\n TTP<\/jats:styled-content>\n (6.75 per 100 admissions; 95%\n CI<\/jats:styled-content>\n 6.74\u20136.79) (\n p<\/jats:italic>\n \u2009<\u20090.001). This included significantly higher rates of acute myocardial infarction, acute renal failure, acute respiratory distress syndrome (\n ARDS<\/jats:styled-content>\n ), disseminated intravascular coagulation (\n DIC<\/jats:styled-content>\n ), pulmonary edema\/acute heart failure, puerperal cerebrovascular disorders, sepsis, shock, air\/thrombotic embolism, blood transfusion, and mechanical ventilation. Amongst fetal outcomes, fetal growth restriction (6.9% vs. 2.3%) was more common in\n TTP<\/jats:styled-content>\n , while there was no statistical difference between the two groups in rates of preterm delivery. In the multivariate analysis, Charlson comorbidity index (\n CCI<\/jats:styled-content>\n )\u2009\u2265\u20091 and age\u2009\u2265\u200935\u2009years were associated with higher likelihood of morbidity.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Pregnancy associated with TTP is associated with inferior maternal and fetal health outcomes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/trf.18442","type":"journal-article","created":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T06:02:08Z","timestamp":1759903328000},"page":"2406-2413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Fetal and maternal morbidity in pregnant patients with thrombotic thrombocytopenic purpura: A Nationwide analysis"],"prefix":"10.1111","volume":"65","author":[{"given":"Amir A.","family":"Mahmoud","sequence":"first","affiliation":[{"name":"Division of Hematology, Department of Medicine Washington University School of Medicine in St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Basant","family":"Eltaher","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rochester General Hospital New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purva","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rochester General Hospital New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana","family":"Antun","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Emory University Atlanta Georgia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1380-3799","authenticated-orcid":false,"given":"Camila","family":"Masias","sequence":"additional","affiliation":[{"name":"Division of Hematology Baptist Health South Florida Florida USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meera","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Internal Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shruti","family":"Chaturvedi","sequence":"additional","affiliation":[{"name":"Division of Hematology, Department of Medicine Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.03422.x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-01-549469"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-022-04936-2"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13023-014-0193-6"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-02-553131"},{"key":"e_1_2_9_7_1","unstructured":"CDC.Severe maternal morbidity in the United States. Reproductive health.2024https:\/\/www.cdc.gov\/maternal-infant-health\/php\/severe-maternal-morbidity\/index.html"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2022-002752"},{"key":"e_1_2_9_9_1","unstructured":"HouchensRRD ElixhauserA.Final report on calculating national inpatient sample (NIS) variances for data years 2012 and later. 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