{"doi":"10.1111/trf.18442","title":"Fetal and maternal morbidity in pregnant patients with thrombotic thrombocytopenic purpura: A Nationwide analysis","abstract":"BACKGROUND: Pregnancy is a known trigger for thrombotic thrombocytopenia purpura (TTP); however, there is limited data on the impact of a TTP diagnosis on pregnancy outcomes. STUDY DESIGN: We used retrospective data from the National Inpatient Sample database to identify all hospital admissions of pregnant patients (≥18 years), with and without TTP from 2012 to 2021 using ICD-9/10 codes. To describe the impact of TTP on maternal and fetal morbidity, we identified different morbidity indicators using standard CDC definitions. RESULTS: We identified 7,397,411 pregnancy hospitalizations with a mean age of 29 years. Of these, 233 had TTP, with 73 receiving therapeutic plasma exchange (TPE) during admission, which was treated as a surrogate for active TTP. Severe maternal morbidity rates were several-fold higher in women with TTP (133 per 100 admissions; 95% CI 112-155) compared to those without TTP (6.75 per 100 admissions; 95% CI 6.74-6.79) (p < 0.001). This included significantly higher rates of acute myocardial infarction, acute renal failure, acute respiratory distress syndrome (ARDS), disseminated intravascular coagulation (DIC), pulmonary edema/acute heart failure, puerperal cerebrovascular disorders, sepsis, shock, air/thrombotic embolism, blood transfusion, and mechanical ventilation. Amongst fetal outcomes, fetal growth restriction (6.9% vs. 2.3%) was more common in TTP, while there was no statistical difference between the two groups in rates of preterm delivery. In the multivariate analysis, Charlson comorbidity index (CCI) ≥ 1 and age ≥ 35 years were associated with higher likelihood of morbidity. CONCLUSION: Pregnancy associated with TTP is associated with inferior maternal and fetal health outcomes.","journal":"Transfusion","year":2025,"id":527114,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6333,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1403255,"name":"Basant Eltaher","orcid":"0000-0003-1255-0408","position":1,"is_corresponding":false},{"id":877460,"name":"Purva Shah","orcid":"0009-0009-4560-0230","position":2,"is_corresponding":false},{"id":450518,"name":"Ana G. Antun","orcid":null,"position":3,"is_corresponding":false},{"id":870938,"name":"Camila Masias","orcid":"0000-0002-1380-3799","position":4,"is_corresponding":false},{"id":755679,"name":"Meera Sridharan","orcid":"0000-0001-7225-8228","position":5,"is_corresponding":false},{"id":230446,"name":"Shruti Chaturvedi","orcid":"0000-0001-6832-2389","position":6,"is_corresponding":false},{"id":1311250,"name":"Amir Mahmoud","orcid":"0000-0002-0630-1117","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T02:50:34.851930Z","pmid":"41058144","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}