Pregnancy complications in acquired thrombotic thrombocytopenic purpura: a case-control study

Barbara Ferrari, Alberto Maino, Luca A. Lotta, Andrea Artoni, Silvia Pontiggia, Silvia M. Trisolini, Alessandra Malato, Frits R. Rosendaal, Flora Peyvandi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

BACKGROUND: Pregnant women with a history of acquired thrombotic thrombocytopenic purpura (TTP) are considered at risk for disease recurrence and might be at risk for miscarriage, similar to other autoimmune disorders. However, the exact entity of these risks and their causes are unknown. The aim of this study was to evaluate risk factors associated with adverse pregnancy outcome, in terms of both gravidic TTP and miscarriage, in women affected by previous acquired TTP.

METHODS: We conducted a nested case-control study in women with a history of acquired TTP enrolled in the Milan TTP registry from 1994 to October 2012, with strict inclusion criteria to reduce referral and selection bias.

RESULTS: Fifteen out of 254 women with acquired TTP were included, namely four cases with gravidic TTP, five with miscarriage, and six controls with uncomplicated pregnancy. In the cases, ADAMTS13 activity levels in the first trimester were moderately-to-severely reduced (median levels

CONCLUSIONS: ADAMTS13 activity evaluation and detection of anti-ADAMTS13 antibody could help to predict the risk of complications in pregnant women with a history of acquired TTP.

Original languageEnglish
Pages (from-to)193
Number of pages1
JournalOrphanet Journal of Rare Diseases
Volume9
DOIs
Publication statusPublished - 2014

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Pregnancy Complications
Case-Control Studies
Thrombotic Thrombocytopenic Purpura
Spontaneous Abortion
Pregnant Women
Selection Bias
First Pregnancy Trimester
Pregnancy Outcome
Registries
Anti-Idiotypic Antibodies
Referral and Consultation
Acquired Thrombotic thrombocytopenic purpura
Recurrence
Pregnancy

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Pregnancy complications in acquired thrombotic thrombocytopenic purpura : a case-control study. / Ferrari, Barbara; Maino, Alberto; Lotta, Luca A.; Artoni, Andrea; Pontiggia, Silvia; Trisolini, Silvia M.; Malato, Alessandra; Rosendaal, Frits R.; Peyvandi, Flora.

In: Orphanet Journal of Rare Diseases, Vol. 9, 2014, p. 193.

Research output: Contribution to journalArticle

Ferrari, Barbara ; Maino, Alberto ; Lotta, Luca A. ; Artoni, Andrea ; Pontiggia, Silvia ; Trisolini, Silvia M. ; Malato, Alessandra ; Rosendaal, Frits R. ; Peyvandi, Flora. / Pregnancy complications in acquired thrombotic thrombocytopenic purpura : a case-control study. In: Orphanet Journal of Rare Diseases. 2014 ; Vol. 9. pp. 193.
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AU - Artoni, Andrea

AU - Pontiggia, Silvia

AU - Trisolini, Silvia M.

AU - Malato, Alessandra

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N2 - BACKGROUND: Pregnant women with a history of acquired thrombotic thrombocytopenic purpura (TTP) are considered at risk for disease recurrence and might be at risk for miscarriage, similar to other autoimmune disorders. However, the exact entity of these risks and their causes are unknown. The aim of this study was to evaluate risk factors associated with adverse pregnancy outcome, in terms of both gravidic TTP and miscarriage, in women affected by previous acquired TTP.METHODS: We conducted a nested case-control study in women with a history of acquired TTP enrolled in the Milan TTP registry from 1994 to October 2012, with strict inclusion criteria to reduce referral and selection bias.RESULTS: Fifteen out of 254 women with acquired TTP were included, namely four cases with gravidic TTP, five with miscarriage, and six controls with uncomplicated pregnancy. In the cases, ADAMTS13 activity levels in the first trimester were moderately-to-severely reduced (median levels CONCLUSIONS: ADAMTS13 activity evaluation and detection of anti-ADAMTS13 antibody could help to predict the risk of complications in pregnant women with a history of acquired TTP.

AB - BACKGROUND: Pregnant women with a history of acquired thrombotic thrombocytopenic purpura (TTP) are considered at risk for disease recurrence and might be at risk for miscarriage, similar to other autoimmune disorders. However, the exact entity of these risks and their causes are unknown. The aim of this study was to evaluate risk factors associated with adverse pregnancy outcome, in terms of both gravidic TTP and miscarriage, in women affected by previous acquired TTP.METHODS: We conducted a nested case-control study in women with a history of acquired TTP enrolled in the Milan TTP registry from 1994 to October 2012, with strict inclusion criteria to reduce referral and selection bias.RESULTS: Fifteen out of 254 women with acquired TTP were included, namely four cases with gravidic TTP, five with miscarriage, and six controls with uncomplicated pregnancy. In the cases, ADAMTS13 activity levels in the first trimester were moderately-to-severely reduced (median levels CONCLUSIONS: ADAMTS13 activity evaluation and detection of anti-ADAMTS13 antibody could help to predict the risk of complications in pregnant women with a history of acquired TTP.

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