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dc.contributor.CRUESPUniversidade Estadual de Campinaspt_BR
dc.typeArtigo de periódicopt_BR
dc.titleA prospective study on the prevalence and risk factors for neonatal thrombocytopenia and platelet alloimmunization among 9332 unselected Brazilian newbornspt_BR
dc.contributor.authorCastro, Vpt_BR
dc.contributor.authorKroll, Hpt_BR
dc.contributor.authorOriga, AFpt_BR
dc.contributor.authorFalconi, MApt_BR
dc.contributor.authorMarques, SBDpt_BR
dc.contributor.authorMarba, STpt_BR
dc.contributor.authorPassini, Rpt_BR
dc.contributor.authorAnnichino-Bizzacchi, JMpt_BR
dc.contributor.authorCosta, FFpt_BR
dc.contributor.authorSantoso, Spt_BR
dc.contributor.authorArruda, VRpt_BR
unicamp.authorUniv Estadual Campinas, Hematol & Transfus Ctr, UNICAMP, Dept Neonatol, Campinas, SP, Brazil Univ Estadual Campinas, Dept Obstet & Gynecol, UNICAMP, Campinas, SP, Brazil NSTOB Inst, German Red Cross Blood Transfus Serv, Dessau, Germany Univ Giessen, Inst Clin Immunol & Transfus Med, D-6300 Giessen, Germany Univ Penn, Sch Med, Childrens Hosp Philadelphia, Dept Pediat, Philadelphia, PA 19104 USApt_BR
dc.subject.wosFetal Thrombocytopeniapt_BR
dc.subject.wosMaipa Assaypt_BR
dc.description.abstractBACKGROUND: Neonatal thrombocytopenia (NT) occurs in 0.5 to 0.9% of unselected Caucasian newborns. However, the prevalence of this complication in other populations is unknown. In this study the prevalence/causes of NT was determined in Brazilian newborns, a population characterized by admixture among Indigenous, Africans, and Caucasians. STUDY DESIGN: A prospective study was carried out in a 3-year period, to determine the prevalence and causes of thrombocytopenia in cord blood samples. Genotyping for HPA 1-5 systems was performed in pairs of mother/neonates with and without thrombocytopenia. All mothers with genotypic mismatches from each group were tested for HPA-specific antibody using the MAIPA technique to identify alloimmunization. RESULTS: Platelet counts < 100 x 10(9)/L were detected in 1.5% of 9,332 unselected newborns. In 0.15%, platelet count was < 50 x 10(9)/L. Clinically significant bleeding was rare. Underlying diseases were present in 48% of the thrombocytopenic cases. HPA 1-5 system genotype mismatches occurred in 50% of gestations, but did not predict the risk for thrombocytopenia. Notably, mismatched genotypes for HPA-5 were slightly increased in the thrombocytopenic group. The presence of anti-HPA-5b antibodies was observed in 0.05% of unselected pregnancies, but increased to 12% among mothers of neonates with thrombocytopenia and mismatched genotype (N = 51). CONCLUSIONS: Neonatal thrombocytopenia is common among Brazilian newborns at rates comparable with those described among Caucasians. These data suggest that screening for genotypic HPA mismatch, followed by an HPA-specific immunoassay system, particularly for the HPA-5 system, among mothers of newborns with thrombocytopenia in our population would allow the identification of pregnancies at risk of alloimmune
dc.publisherBlackwell Publishingpt_BR
dc.identifier.citationTransfusion. Blackwell Publishing, v. 47, n. 1, n. 59, n. 66, 2007.pt_BR
dc.sourceWeb of Sciencept_BR
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