Immune Thrombocytopenic Purpura and Maternal and Neonatal Outcomes During Pregnancy: A Systematic Review and Meta-Analysis

Abstract

Immune thrombocytopenic purpura (ITP) affects 1–3 out of every 10 000 pregnancies, posing significant risks to both mothers and newborns. The condition often requires careful management to prevent severe hemorrhagic events. PubMed, Embase, Scopus, and Web of Science searched for relevant literature until June 2024. A meta-analysis was performed to evaluate the effect of ITP on maternal and fetal outcomes. The results showed that antepartum hemorrhage occurred in 0.17 (95% CI = 0.12–0.25) of patients and postpartum hemorrhage occurred in 0.11 (95% CI = 0.07–0.16) of pregnant women with ITP. About 0.63 (95% CI = 0.50–0.74) of pregnant women needed treatment for ITP. The cesarean section (CS) rate was 0.48 (95% CI = 0.34–0.61), and the occurrence of preterm labor was 0.14 (95% CI = 0.07–0.24). A total of 0.32 of neonates had thrombocytopenia (95% CI = 0.18–0.52). The difference between the platelet count of those diagnosed with ITP before pregnancy and those diagnosed after pregnancy was significant (MD = –31.50, 95% CI = 51.29–11.72, p < 0.01). This meta-analysis highlights the significant impact of ITP on pregnancy, estimating risks of bleeding, CS, gestational diabetes, preterm labor, and neonatal thrombocytopenia. These findings underscore the need for vigilant monitoring and tailored management of pregnant women with ITP.