Place of HPA1a Antigen in Neonatal Thrombocytopenia to Obstetric and Pediatric Gynecology Hospital of Douala and Laquintinie Hospital of Douala

Abstract

Introduction: Platelet antigens called Human Platelet Antigen (HPA) present on the surface of platelets are involved in immunological conflicts sometimes leading to severe thrombocytopenia related to anti HPA1a antibody. The aim of this study was to detect platelet antibodies in newborns and the associated risk factors. Material and Methods: We conducted a cross-sectional analytical study from 05 January to 30 June 2017 at the Laquintinie Hospital in Douala and the Gynaecological Obstetrics and Paediatrics Hospital in Douala, among newborns with thrombocytopenia and mothers in compliance with ethical considerations. Socio-demographic and clinical data were collected, blood was collected on EDTA tubes for newborns and on tubes without anticoagulant for mothers in order to determine the presence of anti HPA1a antibody. Statistical analysis was performed using SPSS version 22 software. Results: A total of 35 newborns and 35 mothers were recruited in this study.  The mean age of the newborns was 8.5 ± 7.2 days with a sex ratio of 1.7% in favour of boys. The prevalence of neonatal thrombocytopenia was 4.1% and the prevalence of HPA1a antibody was 17.1%. Most of the newborns were born to primiparous mothers (57.1%) and 80.0% had prematurity and neonatal jaundice as reasons for hospitalization. Male newborns and those whose mothers had been transfused at least once during or before pregnancy had respectively 4 (OR = 3.53; p-value < 0.0001) and 14 (OR = 14; p-value = 0.0483) times more risk of having the anti-HPA1a antibody. Conclusion: Our study has shown that the anti-HPA1a antibody is a risk factor for neonatal thrombocytopenia and is associated with maternal transfusion.