Fetomaternal Outcomes in Pregnant Women with Gestational Thrombocytopenia

Abstract

Gestational thrombocytopenia is the most common cause of thrombocytopenia during pregnancy and is generally considered a benign condition. However, its association with adverse maternal and neonatal outcomes remains clinically relevant, particularly in low- and middle-income settings where local evidence is limited. This study aimed to determine fetomaternal outcomes in pregnant women with gestational thrombocytopenia at a tertiary care hospital in Multan. Objective: To determine the fetomaternal outcomes in pregnant women with gestational thrombocytopenia. Methods: This descriptive study was conducted in the Department of Obstetrics and Gynaecology, Ibn-e-Siena Hospital, Multan, from February 2024 to February 2025. A total of 176 pregnant women aged 18–45 years with gestational thrombocytopenia were enrolled through non-probability consecutive sampling. Women with hypertensive disorders of pregnancy, disseminated intravascular coagulation, systemic lupus erythematosus, chronic liver disease, thrombotic thrombocytopenia, and other major secondary causes were excluded. Participants were followed until delivery. Maternal outcomes included gestational age at delivery, antepartum hemorrhage, postpartum hemorrhage, mode of delivery, and stillbirth. Live-born neonates underwent complete blood count testing within 24 hours to assess neonatal thrombocytopenia. Data were analyzed using SPSS version 23, and post-stratification comparisons were performed using the chi-square test with p≤0.05 considered statistically significant. Results: The mean maternal age was 28.94 ± 5.63 years and the mean gravida was 2.71 ± 1.36. Most women were aged 26–35 years (51.7%) and were multigravida (70.5%). The mean gestational age at delivery was 37.61 ± 1.84 weeks. Preterm delivery occurred in 19.3% of cases, antepartum hemorrhage in 6.3%, postpartum hemorrhage in 9.1%, cesarean delivery in 55.1%, stillbirth in 4.5%, and neonatal thrombocytopenia in 6.8% of live births. Advanced maternal age was significantly associated with preterm delivery (p=0.028). Women with a previous history of gestational thrombocytopenia had significantly higher rates of preterm delivery (30.8% vs 16.1%, p=0.041) and neonatal thrombocytopenia (16.7% vs 4.5%, p=0.017). Conclusion: Gestational thrombocytopenia was associated with a measurable burden of adverse fetomaternal outcomes, particularly preterm delivery, cesarean birth, postpartum hemorrhage, and neonatal thrombocytopenia. Women with recurrent gestational thrombocytopenia appeared to represent a higher-risk subgroup and may benefit from closer antenatal and neonatal surveillance.