Observational studyActa obstetricia et gynecologica Scandinavica2025
Improving prediction of fetal/neonatal intracranial hemorrhage in HPA-1a alloimmunized pregnancies to guide antenatal management: An observational cohort study.
Observational study in Acta obstetricia et gynecologica Scandinavica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Rapid anti-HPA-1a antibody quantification with a Luminex bead-based assay: A method evaluation.Vox sanguinis · 2026Article
- Improving prediction of fetal/neonatal intracranial hemorrhage in HPA-1a alloimmunized pregnancies to guide antenatal management: An observational cohort study.Acta obstetricia et gynecologica Scandinavica · 2025Observational
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMaternal alloimmunization against human platelet antigen-1a (HPA-1a) may lead to severe intracranial hemorrhage (ICH) in the fetus or newborn as a life-threatening complication of fetal neonatal alloimmune thrombocytopenia (FNAIT). Most women who are HPA-1a-alloimmunized do not have a fetus/neonate with ICH. In the absence of predictive tools to identify pregnancies with high risk of ICH outcome, most countries offer weekly antenatal IVIg to all recognized HPA-1a-alloimmunized pregnancies. Norwegian FNAIT guidelines are restrictive regarding antenatal IVIg administration and have a long-standing tradition of longitudinal anti-HPA-1a antibody measurements when at-risk pregnancies are identified, facilitating exploration of the natural history of alloimmunized pregnancies. We aimed to explore associations between maternal anti-HPA-1a antibody levels and risk of fetal/neonatal ICH in non-IVIg treated HPA-1a alloimmunized pregnancies and assess if an antibody level threshold can be useful for identifying pregnancies with increased ICH risk. MATERIAL AND
methodsWe compared anti-HPA-1a levels both from clinically referred and prospectively identified, non-IVIg treated, HPA-1a-immunized pregnancies stratified by previous neonatal FNAIT outcome (ICH or FNAIT without ICH) in Norway 1997-2023.
resultsAnti-HPA-1a levels in pregnancies with ICH outcome were higher (median 29.6 IU/mL, range 0.1-222.1, n = 15) compared to no ICH FNAIT pregnancies (median 10.4 IU/mL, range 0.0-83.1, n = 55; p = 0.046, Mann-Whitney U test). A suggestive anti-HPA-1a threshold of 70 IU/mL was chosen based on receiver operating characteristic (ROC) analysis, with high specificity values (96.4%).
conclusionAntenatal anti-HPA-1a levels may be useful when assessing the risk of ICH outcome and may enable a more targeted antenatal IVIg treatment both in a nonscreening and screening situation.
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