Abstract
It is unclear whether women with immune thrombotic thrombocytopenic purpura (iTTP) are counseled regarding the risks during pregnancy or strategies to improve outcomes.This study aimed to understand how iTTP affects reproductive decisions and to describe outcomes of pregnancies after iTTP diagnosis.iTTP is characterized by recurrent episodes of thrombotic microangiopathy and ischemic organ failure due to a severe deficiency of ADAMTS13. 1 Pregnancy is a known trigger for an initial episode or relapse of iTTP.2,3 Outcomes of pregnancy in women with iTTP are poor and include high rates of iTTP relapse, pregnancy loss, and preeclampsia.[4][5][6][7] However, prophylactic immunosuppression and ADAMTS13 monitoring can improve maternal and fetal outcomes in pregnancy.[6][7][8] Moreover, at least in the United States, iTTP is a condition that disproportionately affects Black women, 9,10 who are already at higher risk of adverse pregnancy outcomes 11,12 predominantly because of social determinants of health.