(1015) Maternal Immune Thrombocytopenia and Risk of Severe Hemorrhagic Morbidity at Delivery

 To perform an updated analysis to evaluate the association between immune thrombocytopenia (ITP) and severe maternal morbidity (SMM) during admission for delivery.

Study Design:
We conducted a population-based cross-sectional study using the most recent National Inpatient Sample (NIS) data from 2016–2022. We identified delivery admissions in patients aged 10–60 years, with and without a diagnosis of ITP (ICD-10: D69.3). The primary outcome was composite SMM, as defined by the Centers for Disease Control and Prevention, among patients with and without ITP. Previously established comorbidity index (CI) was used to control for additional comorbidities. Logistic regression was used to evaluate the association between ITP and SMM, controlling for the number of CI.

Results:
Our analysis identified 5,027,079 delivery admissions, of which 5,699 individuals carried a diagnosis of ITP. SMM occurs in 8.7 percent of delivery admissions with ITP and 1.8 percent of delivery admissions without ITP. Patients with ITP were significantly more likely to experience SMM during the delivery admission (OR 2.5, CI 2.3 – 2.8, p < 0.001) after controlling for CI.

Conclusion:
ITP is a rare disorder in pregnancy; however, it carries an approximately four-fold increased risk of SMM during delivery admission. These findings underscore the importance of preconception counseling for patients with known ITP and the need for complex delivery planning for pregnant patients with ITP.