Prenatal blood test may prevent serious bleeding in babies

Each year, in the Netherlands, 4 to 7 children suffer a severe brain hemorrhage before or shortly after birth, due to the rare platelet disease FNAIT (Fetal and Neonatal Allo-immune Thrombocytopenia), which may be fatal. That is the outcome of large-scale research by Sanquin and the LUMC.

The collected data support decision making on prenatal screening worldwide, a desire that has been around for decades. There is a treatment to prevent FNAIT, but that requires a timely diagnosis. Therefore prenatal screening is needed. To determine whether that is justified, it was necessary to determine the prevalence of FNAIT. The results of the study, published in the Lancet Haematology, will be presented to the Health Council of the Netherlands for consideration.

FNAIT resembles rhesus disease; also called hemolytic disease of the fetus and newborn (HDFN). The important difference is that severe FNAIT can occur already during the first pregnancy. In subsequent pregnancies, the risk is known and women will weekly receive antibodies from donor plasma to prevent bleeding in the baby. But in first pregnancies, FNAIT often goes unnoticed until the baby gets sick. Screening all pregnant women could save those babies.

The research was initiated by Professor Ellen van der Schoot (Sanquin), together with Professors Dick Oepkes (LUMC) and Masja de Haas (Sanquin/LUMC). Two researchers successively obtained their doctorates on the study: Dian Winkelhorst and Thijs de Vos.

Read more: Natural historyx of human platelet antigen 1a-alloimmunised pregnancies: a prospective observational cohort study - The Lancet Haematology