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Journal of Pregnancy
Volume 2016, Article ID 8297407, 8 pages
http://dx.doi.org/10.1155/2016/8297407
Research Article

Pregnancy and Birth Outcomes among Women with Idiopathic Thrombocytopenic Purpura

1Pregistry, Los Angeles, CA 90045, USA
2Epidemiology, OptumInsight, Waltham, MA 02451, USA
3Children’s Hospital Boston, Boston, MA 02115, USA
4Medical Genetics Institute, Cedars Sinai Medical Center, Los Angeles, CA 90048, USA
5Palo Alto Medical Foundation, Mountain View, CA 94040, USA
6Department of Pediatrics, Division of Genetics, University of California, San Francisco, San Francisco, CA 94115, USA
7College of Public Health, University of South Florida, Tampa, FL 33612, USA
8Department of Medicine, Division of Pharmacoeconomics and Pharmacoepidemiology, Brigham & Women’s Hospital, Harvard Medical School, Boston, MA 02120, USA

Received 29 October 2015; Accepted 3 March 2016

Academic Editor: Albert Fortuny

Copyright © 2016 Diego F. Wyszynski et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To examine pregnancy and birth outcomes among women with idiopathic thrombocytopenic purpura (ITP) or chronic ITP (cITP) diagnosed before or during pregnancy. Methods. A linkage of mothers and babies within a large US health insurance database that combines enrollment data, pharmacy claims, and medical claims was carried out to identify pregnancies in women with ITP or cITP. Outcomes included preterm birth, elective and spontaneous loss, and major congenital anomalies. Results. Results suggest that women diagnosed with ITP or cITP prior to their estimated date of conception may be at higher risk for stillbirth, fetal loss, and premature delivery. Among 446 pregnancies in women with ITP, 346 resulted in live births. Women with cITP experienced more adverse outcomes than those with a pregnancy-related diagnosis of ITP. Although 7.8% of all live births had major congenital anomalies, the majority were isolated heart defects. Among deliveries in women with cITP, 15.2% of live births were preterm. Conclusions. The results of this study provide further evidence that cause and duration of maternal ITP are important determinants of the outcomes of pregnancy.