Preventing severe bleeding in babies

The blood of a pregnant woman may contain antibodies that break down the baby's platelets. Dian Winkelhorst assesed how often this occurs and investigated whether it would be advisable to screen for it in the future. She will defend her thesis on this research on 26 November 2019. Dian talks about her study here:

"With my research I want to find out whether in the future we should also check the blood of pregnant women for antibodies against blood platelets. In rare cases, these can lead to a shortage of blood platelets and bleeding in the baby. We call this Foetal/Neonatal Immune Thrombocytopenia (FNAIT). During my PhD-research I made an inventory of how frequently this happened and I worked on developing better tests. Early screening during pregnancy and timely treatment with antibodies from donor plasma (IVIg) can prevent FNAIT".

HIP study

"For the purposes of the study, called the HIP study, we measure the platelet blood type in pregnant women. They could produce antibodies if the blood group is missing, while their baby is positive. We also measure these antibodies. We subsequently ask the midwife or obstetrician about the baby's health after birth. All results are stored anonymously, it's all about making an inventory. We ask pregnant women who are Rhesus D- and c-negative to participate in the study. It is important that all of them take part in the study, because we are only allowed to use the blood that remains after the routine screening during the pregnancy, with the consent of the pregnant woman. That blood sample is already at Sanquin. This means that there is no need to draw extra blood. For a future diagnostic assay we are investigating which antibodies against blood platelets are harmful and to what exactly they bind".

Platelet blood group

"The platelet blood group, HPA-1a, is also found on blood vessel cells and cells of the placenta. If antibodies also bind to it, they could possibly do more harm. The sugar composition of antibodies may also show how dangerous they are. Once the study has been completed and everything analyzed, we will know whether it is advisable in the future to also screen for FNAIT, with the aim of preventing serious bleeding in babies. Perhaps it is possible to develop a preventive treatment, just like the anti-D". 

Dian Winkelhorst is a physician-researcher. On 26 November 2019 (10:00) she will defend her PhD thesis 'Fetal and Neonatal Alloimmune Thrombocytopenia evidence based screening' at Leiden University. She carried out her research at Sanquin/LUMC. In 2017, she was awarded an important prize in the field of obstetrics for setting up the HIP study.

The HIP study is still in full swing. More than 37,500 women are already included in the research. Because the platelet blood group that is being searched for is so rare, many women are needed for the success of the study. The researchers are therefore still striving to have some 10,000 extra women participate. The data from the last part will be collected in 2020. The team is extremely grateful for the participation of these women and the care providers who inform women about the study.

Thijs de Vos, physician-researcher, has now taken over the baton from Dian.