{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T17:32:12Z","timestamp":1789234332675,"version":"build-2803163510"},"reference-count":31,"publisher":"American Society of Hematology","issue":"1","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The risk of immune thrombocytopenia (ITP) worsening during pregnancy and neonatal ITP\u00a0(NITP) have never been prospectively studied. We included 180 pregnant and 168\u00a0nonpregnant women with ITP in a prospective, multicenter, observational cohort study. A total of 131 pregnant women with ITP were matched to 131 nonpregnant women with ITP by history of splenectomy, ITP status (no response, response, complete response), and duration. Groups were followed for 15 months. The primary outcome was the first occurrence of ITP worsening defined by a composite end point including bleeding events and\/or severe thrombocytopenia (&amp;lt;30\u00a0\u00d7 109\/L) and\/or ITP treatment modification. We also studied the recurrence of ITP worsening and the incidence of NITP and risk factors. The first occurrence of ITP worsening did not differ between pregnant and nonpregnant women with ITP (53.4 per 100 person-years [95% confidence interval {CI}, 40.8-69.9] vs 37.1 [95% CI, 27.5-50.0]; hazard ratio {HR}, 1.35 [95% CI, 0.89-2.03], P\u00a0= .16). Pregnant women with ITP were more likely to have recurrence of severe thrombocytopenia and treatment modification (HR, 2.71 [95% CI, 1.41-5.23], P\u00a0= .003; HR, 2.01 [95% CI, 1.14-3.57], P\u00a0= .017, respectively). However, recurrence of severe bleeding events was not different between groups (P\u00a0= .4). Nineteen (14%) neonates showed NITP &amp;lt;50\u00a0\u00d7 109\/L. By multivariable analysis, NITP was associated with a previous offspring with NITP and maternal platelet count &amp;lt;50\u00a0\u00d7 109\/L within 3 months before delivery (adjusted odds ratio, 5.55 [95% CI, 1.72-17.89], P\u00a0= .004 and 4.07 [95% CI, 1.41-11.73], P\u00a0= .009). To conclude, women with ITP do not increase their risk of severe bleeding during pregnancy. NITP is associated with NITP history and the severity of maternal ITP during pregnancy. These results will be useful for counseling women with ITP.<\/jats:p>","DOI":"10.1182\/blood.2022017277","type":"journal-article","created":{"date-parts":[[2022,9,2]],"date-time":"2022-09-02T21:03:06Z","timestamp":1662152586000},"page":"11-21","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":44,"title":["Immune thrombocytopenia and pregnancy: an\u00a0exposed\/nonexposed cohort study"],"prefix":"10.1182","volume":"141","author":[{"given":"St\u00e9phanie","family":"Guillet","sequence":"first","affiliation":[{"name":"1Service de M\u00e9decine Interne, Centre national de r\u00e9f\u00e9rence des cytop\u00e9nies auto-immunes de l\u2019adulte, H\u00f4pital Henri Mondor, Assistance Publique H\u00f4pitaux de Paris (AP-HP), Universit\u00e9 Paris Est Cr\u00e9teil, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentine","family":"Loustau","sequence":"additional","affiliation":[{"name":"1Service de M\u00e9decine Interne, Centre national de r\u00e9f\u00e9rence des cytop\u00e9nies auto-immunes de l\u2019adulte, H\u00f4pital Henri Mondor, Assistance Publique H\u00f4pitaux de Paris (AP-HP), Universit\u00e9 Paris Est Cr\u00e9teil, Cr\u00e9teil, France"},{"name":"2Service de M\u00e9decine Interne, Centre Hospitalier Alpes L\u00e9man, Contamine sur Arve, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuelle","family":"Boutin","sequence":"additional","affiliation":[{"name":"3Unit\u00e9 de Recherche Clinique (URC Mondor), AP-HP, H\u00f4pitaux Universitaires Henri Mondor, Cr\u00e9teil, France"},{"name":"4Univ Paris Est Cr\u00e9teil, INSERM, IMRB, Equipe CEpiA (Clinical Epidemiology and Ageing), Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anissa","family":"Zarour","sequence":"additional","affiliation":[{"name":"3Unit\u00e9 de Recherche Clinique (URC Mondor), AP-HP, H\u00f4pitaux Universitaires Henri Mondor, Cr\u00e9teil, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Comont","sequence":"additional","affiliation":[{"name":"5Service de M\u00e9decine Interne et d\u2019Immunopathologie\u2013IUCT-Oncopole, CHU de Toulouse, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Odile","family":"Souchaud-Debouverie","sequence":"additional","affiliation":[{"name":"6Service de M\u00e9decine Interne, CHU de Poitiers, Poitiers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Costedoat Chalumeau","sequence":"additional","affiliation":[{"name":"7Service de M\u00e9decine Interne, Centre de R\u00e9f\u00e9rence Maladies Auto-immunes et Syst\u00e9miques Rares, H\u00f4pital Cochin, AP-HP, Universit\u00e9 de Paris, Paris, France"},{"name":"8Centre for Clinical Epidemiology, H\u00f4pital H\u00f4tel-Dieu, AP-HP, Universit\u00e9 de Paris, Centre of Research in Epidemiology and Statistics, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9853-2635","authenticated-orcid":false,"given":"Brigitte","family":"Pan-Petesch","sequence":"additional","affiliation":[{"name":"9Service d\u2019H\u00e9matologie, CHU Brest, Universit\u00e9 de Brest, Brest, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Gobert","sequence":"additional","affiliation":[{"name":"10Service de M\u00e9decine Interne, H\u00f4pital Saint Antoine, AP-HP, Sorbonne Universit\u00e9, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phane","family":"Cheze","sequence":"additional","affiliation":[{"name":"11Institut d\u2019H\u00e9matologie de Basse-Normandie, Centre Hospitalier de Caen Normandie, Caen, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7500-9323","authenticated-orcid":false,"given":"Jean 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