机构：[1]Peking University People’s Hospital, Beijing, P.R. China[2]Peking University Institute of Hematology, Beijing, P.R. China[3]National Clinical Research Center for Hematologic Disease, Beijing, P.R. China[4]Collaborative Innovation Center of Hematology, Beijing, P.R. China[5]Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People’s Hospital, Beijing, P.R. China[6]Departments of Hematology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China[7]Department of Obstetrics and Gynecology, Peking University People’s Hospital, Beijing, P.R. China[8]Center of Hematologic Diseases, First Affiliated Hospital of Xinjiang Medical University, Ürümqi, P.R. China[9]Department of Hematology, Navy General Hospital, Beijing, P.R. China[10]Department of Hematology, People’s Hospital of Hainan Province, Haikou, P.R.[11]State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Disease Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, P.R. China[12]Department of Hematology, First People’s Hospital of Hangzhou, Hangzhou, P.R. China[13]Department of Hematology, First People’s Hospital of Yunnan Province, Kunming, P.R.China内科片血液内科云南省第一人民医院[14]Department of Hematology, Hebei Institute of Hematology, The Second Hospital of Hebei Medical University, Shijiazhuang, P.R. China[15]Department of Hematology, He Ping Central Hospital of the Changzhi Medical College, Changzhi, P.R. China[16]Department of Hematology, Second Hospital of Shanxi Medical University, Taiyuan, P.R. China[17]Fujian Institute of Hematology, Fujian Provincial Key Laboratory of Hematology, Fujian Medical University Union Hospital, Fuzhou, P.R. China[18]Department of Hematology, Third Affiliated Hospital of Southern Medical University, Guangzhou, P.R. China[19]Department of Hematology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, P.R. China[20]Department of Hematology, Beijing Tongren Hospital, Beijing, P.R. China首都医科大学附属同仁医院[21]Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, P.R. China北京大学深圳医院深圳市康宁医院深圳医学信息中心[22]Department of Hematology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, P.R. China[23]Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, P.R. China[24]Department of Clinical Epidemiology, Peking University People’s Hospital, Beijing, P.R. China[25]Department of Internal Medicine, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, P.R. China[26]CAS Key Laboratory of Genomic and Precision Medicine, Collaborative Innovation Center of Genetics and Development, Beijing Institute of Genomics, Chinese Academy of Sciences, China National Center for Bioinformation, Beijing, P.R. China[27]Peking University People’s Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, P.R. China[28]National Clinical Research Center for Hematologic Disease, Beijing, P.R. China
Background: The responses of intravenous immunoglobulin (IVIg) or corticosteroids as the initial treatment on pregnancy with ITP were unsatisfactory. This study aimed to assess the safety and effectiveness of prednisone plus IVIg versus prednisone or IVIg in pregnant patients with immune thrombocytopenia (ITP). Methods: Between 1 January 2010 and 31 December 2020, 970 pregnancies diagnosed with ITP at 19 collaborative centers in China were reviewed in this observational study. A total of 513 pregnancies (52.89%) received no intervention. Concerning the remaining pregnancies, 151 (33.04%) pregnancies received an initial treatment of prednisone plus IVIg, 105 (22.98%) pregnancies received IVIg alone, and 172 (37.64%) pregnancies only received prednisone. Results: Regarding the maternal response to the initial treatment, no differences were found among the three treatment groups (41.1% for prednisone plus IVIg, 33.1% for prednisone, and 38.1% for IVIg). However, a significant difference was observed in the time to response between the prednisone plus IVIg group (4.39 +/- 2.54days) and prednisone group (7.29 +/- 5.01 days; p <0.001), and between the IVIg group (6.71 +/- 4.85 days) and prednisone group (p<0.001). The median prednisone duration in the monotherapy group was 27days (range, 8-195days), whereas that in the combination group was 14days (range, 6-85 days). No significant differences were found among these three treatment groups in neonatal outcomes, particularly concerning the neonatal platelet counts. The time to response in the combination treatment group was shorter than prednisone monotherapy. The duration of prednisone application in combination group was shorter than prednisone monotherapy. The combined therapy showed a lower predelivery platelet transfusion rate than IVIg alone. Conclusion: These findings suggest that prednisone plus IVIg may represent a potential combination therapy for pregnant patients with ITP.
基金：
National Key Research and Development Program of China [2021YFC2500300]; National Natural Science Foundation of China [81970113]; Key Program of National Natural Science Foundation of China [81730004]; Capital Health Research and Development of Special [2022-1-4082]
第一作者机构：[1]Peking University People’s Hospital, Beijing, P.R. China[2]Peking University Institute of Hematology, Beijing, P.R. China[3]National Clinical Research Center for Hematologic Disease, Beijing, P.R. China[4]Collaborative Innovation Center of Hematology, Beijing, P.R. China[5]Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Peking University People’s Hospital, Beijing, P.R. China
共同第一作者：
通讯作者：
通讯机构：[27]Peking University People’s Hospital, Peking University Institute of Hematology, No. 11 Xizhimen South Street, Xicheng District, Beijing 100044, P.R. China[28]National Clinical Research Center for Hematologic Disease, Beijing, P.R. China
推荐引用方式(GB/T 7714)：
Xiao-Lu Zhu,Ru Feng,Qiu-Sha Huang,et al.Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy: a national retrospective cohort study[J].THERAPEUTIC ADVANCES IN HEMATOLOGY.2022,13:doi:10.1177/20406207221095226.
APA：
Xiao-Lu Zhu,Ru Feng,Qiu-Sha Huang,Mei-Ying Liang,Ming Jiang...&Xiao-Hui Zhang.(2022).Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy: a national retrospective cohort study.THERAPEUTIC ADVANCES IN HEMATOLOGY,13,
MLA：
Xiao-Lu Zhu,et al."Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy: a national retrospective cohort study".THERAPEUTIC ADVANCES IN HEMATOLOGY 13.(2022)
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