(453) Platelet Count Trends Across Consecutive Deliveries in Women with Gestational Thrombocytopenia

Objective:
To evaluate whether women with gestational thrombocytopenia (GT), defined as a platelet count (PLT) < 150,000/µL at the time of delivery, are at increased risk for recurrent thrombocytopenia in subsequent pregnancies, and to identify clinical or hematologic patterns that may predict recurrence.

Study Design:
A retrospective cohort study conducted at secondary-level public hospital between 2018 and 2022. Women with at least four deliveries, and with GT identified in one of them, were included. Exclusion criteria included multiple gestation, liver dysfunction, hypertensive disorders, hematologic diseases (including ITP), and viral infections (e.g., COVID-19). Data included demographic and obstetric variables, and PLT values from each delivery. Statistical analysis included Wilcoxon signed-rank tests and unadjusted logistic regression.

Results:

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  A total of 443 women were included.
  



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  There was no significant overall trend in platelet counts between the first delivery with thrombocytopenia and subsequent deliveries (p = 0.92 for first vs. second delivery).
  



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  Approximately 35% of women with platelet counts of 120–150 K/µL in their first thrombocytopenic delivery had normalized counts ( >150 K/µL) in subsequent births.
  



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  Women with PLT < 80 K/µL showed a tendency toward persistently low counts across future deliveries.
  



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  Unadjusted logistic regression demonstrated no significant association between PLT ≤150 K/µL at the second delivery and maternal age, parity, inter-delivery interval, neonatal sex, birthweight, or Rh status.
  

Conclusion:
Most women with GT do not experience a progressively worsening course in subsequent deliveries. While a minority demonstrate persistently low or worsening platelet trends, a considerable proportion recover to normal counts. These findings support a conservative approach to managing GT in the absence of other risk factors and emphasize the need for individualized risk assessment in future pregnancies.