Screening primiparous women and newborns for fetal/neonatal alloimmune thrombocytopenia: a prospective comparison of effectiveness and costs. Immune Thrombocytopenia Working Group

Am J Perinatol. 1996 Oct;13(7):423-31. doi: 10.1055/s-2007-994382.

Abstract

A prospective study was conducted in three maternity wards to compare the medical outcomes and the costs of two screening strategies for the detection of fetal/neonatal alloimmune thrombocytopenia (FMAIT). A total of 2066 primiparas and 6081 newborns were included. Fifty-two primiparous women with HPA-1b phenotype were found, and 45 were followed during pregnancy. Four women developed antibodies, and two fetuses exhibited FMAIT; therefore, the prevalence of anti-HPA-1a was 2 per 1000, and the prevalence of FMAIT 1 per 1000. Forty-eight thrombocytopenic newborns were found out of a total of 5632 blood samples. Five were HPA-1a children whose mothers were HPA-1b. The cost-effectiveness of screening all primiparous women was $45,000 and of screening all newborns is $18,000-per anti-HPA-1a alloimmunization diagnosed. Costs per fetal death or disability averted were $500,000 for the primiparous strategy and $225,000 for the newborn strategy. In conclusion, screening newborns for neonatal alloimmune thrombocytopenia is more cost-effective than screening primiparous women.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antigens, Human Platelet / immunology*
  • Cost-Benefit Analysis
  • Costs and Cost Analysis
  • Epitopes / immunology*
  • Female
  • Fetal Diseases / diagnosis
  • Fetal Diseases / prevention & control*
  • Humans
  • Infant, Newborn
  • Mass Screening / economics*
  • Neonatal Screening / economics*
  • Parity
  • Pregnancy
  • Prospective Studies
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / prevention & control*

Substances

  • Antigens, Human Platelet
  • Epitopes
  • human platelet antigen 1b