Immune and Non-Immune Etiology of Thrombocytopenia: Neonatal and Maternal Causes

Abstract

Neonatal thrombocytopenia (NT) is a common hemostatic abnormalitiy among newborn in the NICU, which increases with the degree of prematurity. It is well documented that this disease has a large range of feasible etiologies. Prematurity, early and late-onset sepsis and asphyxia are the most usual causes of NT. Moreover, FNAIT is the major risk for intracranial hemorrhage in the fetus or newborn. Here, we reviewed the causes for NT, in both newborns and mothers. We demonstrated the factors associated with NT in the newborn including placental insufficiency, fetal and neonatal alloimmune thrombocytopenia (FNAIT), prematurity, sepsis, and asphyxia. The causes of thrombocytopenia in pregnant women and its impact on newborns were also described. This review showed that gestational thrombocytopenia was the most common cause of thrombocytopenia with an incidence of 70-80%, followed by preeclampsia, HELLP and ITP. But neonates born to mothers with immune thrombocytopenia (ITP) had a higher risk for NT and hemorrhagic problems. In ITP, neonatal platelets are destroyed by maternal autoantibodies. We reviewed the causes of thrombocytopenia in neonates and mothers in two groups of immune and nonimmune factors. However, it seems that immunological factors are the most severe form of NT. However, it is necessary to separate NT etiology for differential diagnosis.