Maternal administration of IV Gammaglobulin (IVIG) and/or steroids often increases the typically very low fetal platelet (plt) count of the second sibling (sib) affected by AIT (NEJM 7/3/97). Evaluation of the longterm effects of the disease and of the treatment was conducted in 75 of 113 pairs of sibs, comparing the second treated sib to the untreated first sib. A medical questionnaire was completed by telephone including pediatricians' records. Parents completed the behavioral Assessment System for Children(BASC) to assess behavioral problems. Only significant (p<0.01) differences are shown in the Table below: ICH in the untreated siblings was not responsible for any of the differences between the groups. Despite the tendency of AIT to worsen in subsequent siblings, the treated fetuses appeared medically and neuropsychologically better than their older untreated siblings. Earlier elective delivery of the treated fetuses may have resulted in the increased activity score. In addition to avoiding ICH, treatment of the fetus appears beneficial in the longterm outcome of the neonate with AIT, presumably related to achieving a sustained, higher in utero plt count. We speculate that plts may play an important role in the neuropsychological development of the fetus.

Table 1 No caption available.
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