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Maternal antibody against fetal platelet antigens inherited from the father is a cause of severe thrombocytopenia in the neonate. Most cases of neonatal alloimmune thrombocytopenia (NAIT) are associated with antibodies against the human platelet antigen 1a (HPA-1a). Treatment is usually focused on suppressing the maternal antibodies, but the optimal agents and doses are unclear.
To identify predictors of NAIT severity and assess the efficacy of various prenatal therapeutic approaches, investigators in France conducted a detailed study involving 75 women with anti–HPA-1a. Of these, 66 (88%) had NAIT discovered at time of delivery and had received no prenatal treatment; in these cases, the mean newborn platelet count was 23×109/L. Nine newborn…