Evaluation of a new Swedish protocol for alloimmunization screening during pregnancy

Gottvall, Tomas; Selbing, Anders; Hildén, Jan‐Olof

doi:10.3109/00016349309021130

Cited by 22 publications

(22 citation statements)

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“…We have retrospectively studied all alloimmunizations in the central west region of Sweden during a 14‐year period. The incidence of alloimmunization was 0.4% and this incidence is in agreement with earlier reports (1, 2). The alloimmunization panorama during pregnancy has obviously not changed significantly during the last 15 years.…”

Section: Discussionsupporting

confidence: 92%

Alloimmunization in pregnancy during the years 1992–2005 in the central west region of Sweden

Gottvall

Filbey

2008

Acta Obstet Gynecol Scand

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Section: Discussionsupporting

confidence: 92%

Alloimmunization in pregnancy during the years 1992–2005 in the central west region of Sweden

Gottvall

Filbey

2008

Acta Obstet Gynecol Scand

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“…Even in the age of prophylactic treatment with immune globulin, immunization with anti-D antibody in pregnant women still occurs. The observed prevalence of anti-D immunization in this nationwide cohort from 1982–2002 was 14.1/10,000 births, comparable with previous regional estimates of 14.2/10,000 in 1980–1991 [6] and 12.6/10,000 in 1983–1989 [12]. Although we limited our analysis to data from regions that had achieved a sustained high coverage rate, similar prevalence estimates were obtained from all available data, suggesting that reporting bias is not a serious concern.…”

Section: Discussionsupporting

confidence: 88%

Constructing a Population-Based Research Database from Routine Maternal Screening Records: A Resource for Studying Alloimmunization in Pregnant Women

et al. 2011

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BackgroundAlthough screening for maternal red blood cell antibodies during pregnancy is a standard procedure, the prevalence and clinical consequences of non-anti-D immunization are poorly understood. The objective was to create a national database of maternal antibody screening results that can be linked with population health registers to create a research resource for investigating these issues.Study Design and MethodsEach birth in the Swedish Medical Birth Register was uniquely identified and linked to the text stored in routine maternal antibody screening records in the time window from 9 months prior to 2 weeks after the delivery date. These text records were subjected to a computerized search for specific antibodies using regular expressions. To illustrate the research potential of the resulting database, selected antibody prevalence rates are presented as tables and figures, and the complete data (from more than 60 specific antibodies) presented as online moving graphical displays.ResultsMore than one million (1,191,761) births with valid screening information from 1982–2002 constitute the study population. Computerized coverage of screening increased steadily over time and varied by region as electronic records were adopted. To ensure data quality, we restricted analysis to birth records in areas and years with a sustained coverage of at least 80%, representing 920,903 births from 572,626 mothers in 17 of the 24 counties in Sweden. During the study period, non-anti-D and anti-D antibodies occurred in 76.8/10,000 and 14.1/10,000 pregnancies respectively, with marked differences between specific antibodies over time.ConclusionThis work demonstrates the feasibility of creating a nationally representative research database from the routine maternal antibody screening records from an extended calendar period. By linkage with population registers of maternal and child health, such data are a valuable resource for addressing important clinical questions, such as the etiological significance of non-anti-D antibodies.

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“…We support the recommendation put forward by Wong et al (1997) that routine antenatal antibody screening may not be worth considering for those Rh(D)-positive Chinese women who do not have any history of HDN in their previous pregnancy. Indeed, the current routine antenatal antibody screening practice in most Western countries may not be directly applicable to Chinese community (Davis & Abbott, 1986;Gottvall et al, 1993).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and specificity of clinically significant red cell alloantibodies in Chinese women during pregnancy – a review of cases from 1997 to 2001

Lee

S.K.

Tang

et al. 2003

Transfusion Medicine

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Guidelines for the prevention and management of red cell alloantibodies during pregnancy, related to anti-D in particular, are well established in Caucasian populations. However, because of the racial difference of the blood group distribution, applicability to Chinese is unknown as a result of insufficient data on the prevalence and their outcome. In a retrospective review of 28,303 (21,327 Chinese) antenatal attendances from 1997 to 2001, 213 (0.79%) women were found to have a total of 230 irregular antibodies. About 137 (0.64%) were ethnic Chinese, and a total of 160 irregular antibodies were identified in their blood samples. About 58 of these Chinese women (0.27%) were found to have 66 clinically significant antibodies. There was only one case of anti-D detected in an Rh(D)-negative subject. Our study shows the overall prevalence of clinically significant antibodies in Chinese women, which was not different from that of the Western population. However, the specificities of the antibodies differ with the commonest antibodies encountered; these being anti-Mi (57.6%), anti-E (19.7%), anti-S (10.6%) and anti-c (7.6%). Neonatal jaundice was observed in 37 babies and 10 of them required phototherapy. The findings support the previous recommendation that routine antenatal antibody screening for Chinese women may not be worthwhile except in Rh(D)-negative subjects or those with an antecedent history of haemolytic disease of the newborn (HDN). The relative high incidence of anti-Mi in the present study and the local population, in general, may warrant a large-scale prospective study of pregnancy outcome in these subjects, especially in the light of the previous case reports of HDN because of anti-Mi.

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Evaluation of a new Swedish protocol for alloimmunization screening during pregnancy

Cited by 22 publications

References 4 publications

Alloimmunization in pregnancy during the years 1992–2005 in the central west region of Sweden

Alloimmunization in pregnancy during the years 1992–2005 in the central west region of Sweden

Constructing a Population-Based Research Database from Routine Maternal Screening Records: A Resource for Studying Alloimmunization in Pregnant Women

Prevalence and specificity of clinically significant red cell alloantibodies in Chinese women during pregnancy – a review of cases from 1997 to 2001

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