Place of HPA1a Antigen in Neonatal Thrombocytopenia in Gyneco-Obstetric and Pediatric Hospital of Douala and Laquintinie Hospital of Douala

Abstract

Background: Platelet antigens called human platelet antigens (HPA) present on the surface of platelets are involved in immunological conflicts, sometimes leading to severe thrombocytopenia related to anti-HPA1a antibodies. The aim of this study was to detect platelet antibodies in newborns and the associated risk factors. Methods: We conducted a cross-sectional analytical study from 05 January to 30 June 2017 at the Laquintinie Hospital of Douala and the Gyneco-Obstetric and Pediatric Hospital of Douala among newborns with thrombocytopenia and mothers in compliance with ethical considerations. Socio-demographic and clinical data were collected. Blood was collected on EDTA tubes for newborns and on tubes without anticoagulants for mothers in order to determine the presence of anti-HPA1a antibodies. Statistical analysis was performed using SPSS version 22 software. Results: A total of 35 newborns and 35 mothers were recruited in this study. The mean age of the newborns was 8.5 ± 7.2 days, with a sex ratio of 1.7% in favor of boys. The prevalence of neonatal thrombocytopenia was 4.1%, and the prevalence of HPA1a antibody was 17.1%. Most of the newborns were born to primiparous mothers (57.1%), and 80.0% had prematurity and neonatal jaundice as reasons for hospitalization. Male newborns and those whose mothers had been transfused at least once during or before pregnancy had respectively 4 (OR = 3.53; P-value < 0.0001) and 14 (OR = 14; P-value = 0.0483) times more risk of having the anti-HPA1a antibody. Conclusion: Our study has shown that the anti-HPA1a antibody is a risk factor for neonatal thrombocytopenia and is associated with maternal transfusion.