IVIG Effectively Increased Platelet Counts in Maternal Thrombocytopenia

A recent study that sought to evaluate the efficacy of intravenous immune globulin (IVIG) and identify predictors of platelet response in pregnant persons with moderate-to-severe thrombocytopenia, as well as to optimize clinical decisions and resource use, has found that IVIG effectively increases platelet (PLT) counts. 

Researchers conducted a single-center retrospective cohort study of 79 pregnant persons with moderate-to-severe thrombocytopenia (PLT <100 ×109/L) who received IVIG between 2007 and 2020. Data on maternal demographics, PLT counts, immature platelet fraction (IPF) and IVIG administration were collected. Logistic regression identified predictors of achieving a PLT ≥80 × 109/L and an increment ≥20 × 109/L following IVIG administration.

Results showed the median incremental PLT response following IVIG administration was 16 × 109/L, with 49.4 percent achieving PLT ≥80 × 109/L and 46.8 percent achieving an increment ≥20 × 109/L. Predictors of a favorable response included nadir PLT <30 × 109/L (OR = 6.29), IPF <16  percent (OR = 4.85) and pre-IVIG PLT <50 × 109/L (OR = 8.67). Higher pre-IVIG PLT counts (70-100 ×109/L) were associated with lower odds of achieving a significant PLT increment.

The researchers concluded that IVIG effectively increases PLT counts in pregnant persons with severe thrombocytopenia, especially in those with a nadir PLT <30 × 109/L, IPF <16 percent or pre-IVIG PLT <50 × 109/L. 

According to the researchers, this study highlights the importance of careful patient selection for IVIG to enhance outcomes and conserve resources. And, they recommend future research focus on prospective studies to refine treatment guidelines and resource stewardship of IVIG for maternal thrombocytopenia.