The combined effect of anti-D and non-D Rh antibodies in maternal alloimmunization
Open Access
- 27 September 2021
- journal article
- research article
- Published by Galenos Yayinevi in Journal of Turkish Society of Obstetric and Gynecology
- Vol. 18 (3), 181-189
- https://doi.org/10.4274/tjod.galenos.2021.68822
Abstract
Objective: This study aims to investigate the distribution of antibodies that cause hemolytic disease of the fetus and newborn (HDFN) and compare the clinical outcomes of pregnancies affected by anti-D and anti-D combined with non-D Rh alloimmunization. Materials and Methods: We retrospectively searched and obtained the perinatal and neonatal data of patients with anti-D antibodies and anti-D combined with non-D Rh antibodies (anti-c, -C, -e, -E, and -Kell) from October 2015 to December 2018 at the University of Health Sciences Turkey, Kanuni Sultan Suleyman Training and Research Hospital. Univariate and multiple logistic regression analyses and adjusted odds ratios with their confidence intervals were used to define independent risk factors for non-D antibody positive. Results: The severe fetal hydrops rate was significantly higher in the anti-D combined non-D group (3/25, 12%) than in the anti-D group (1/128, 0.08%, p<0.001). The intrauterine transfusion (IUT) requirement in the anti-D combined non-D group (16/25, 64%) tended to be significantly higher than that in the anti-D group (5/128, 7.46%, p<0.001). The incidence of neonatal exchange transfusion, top-up transfusion, and postnatal phototherapy frequency in the anti-D combined non-D group was significantly higher than in the anti-D group. Conclusion: Anti-D combined with another non-D Rh alloantibody resulted in significantly higher HDFN rates than the anti-D alloimmunized pregnancies. Also, anti-D in association with non-D Rh antibodies resulted in more severe HDFN requiring more invasive treatment procedures, including IUT, neonatal exchange transfusion, or top-up transfusion.Keywords
This publication has 28 references indexed in Scilit:
- Hemolytic disease of the fetus and newborn due to multiple maternal antibodiesAmerican Journal of Obstetrics and Gynecology, 2015
- Prevalence of maternal red cell alloimmunisation: a population study from Queensland, AustraliaPathology, 2015
- Combined Anti e and Anti C Rh Isoimmunisation and Severe HyperbilirubinemiaIndian Journal of Pediatrics, 2015
- Determination of optimal timing of serialin-uterotransfusions in red-cell alloimmunizationUltrasound in Obstetrics & Gynecology, 2014
- Comparison of a gel microcolumn assay with the conventional tube test for red blood cell alloantibody titrationTransfusion, 2012
- The global burden of Rh diseaseArchives of Disease in Childhood: Fetal & Neonatal, 2010
- Red blood cell antibodies in pregnancy and their clinical consequences: synergistic effects of multiple specificitiesTransfusion, 2009
- Risk factors for the presence of non‐rhesus D red blood cell antibodies in pregnancy*BJOG: An International Journal of Obstetrics and Gynaecology, 2009
- Effect of screening for red cell antibodies, other than anti‐D, to detect hemolytic disease of the fetus and newborn: a population study in the NetherlandsTransfusion, 2008
- Diagnosis of fetal anemia with Doppler ultrasound in the pregnancy complicated by maternal blood group immunizationUltrasound in Obstetrics & Gynecology, 1995