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.
Mahmoud et al. (Tue,) studied this question.