Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population

Hassan, Mohd Nazri; Noor, Noor Haslina Mohd; Noor, Shah Reza Johan; Sukri, Salamah Ahmad; Mustafa, Rapiaah; Aster, Hans Van Rostenberghe Luc

doi:10.4103/0973-6247.137449

Cited by 17 publications

(11 citation statements)

References 18 publications

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“…These antibodies can in subsequent pregnancy pass through the placenta and attack foetal red cells carrying the corresponding antigen causing HDFN. Similarly haemolytic transfusion reaction can also occur if the mother is transfused with red cell that are positive for the antigen to which she has developed alloantibodies [13][14][15] . Development of all antibodies can potentially complicate and limits transfusion therapy, contributing to a delay in getting compatible blood, technical complications and sometimes morbidity and mortality.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Rhesus c and e Phenotype Among Pregnant Women Attending Antenatal Clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto.

Erhabor¹

2016

JGNB

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Rhesus (Rh) antigen was discovered in 1940 by Karl Landsteiner and Wiener. In later years, because of its immunogenicity along with ABO antigens, Rh D antigen testing was made mandatory before issuing a compatible blood. Presently there are five major Rh antigens (D, C, E, c and e) in the Rh blood group system. The aim is this study is to determine the prevalence of Rh c and e phenotype among pregnant women attending antenatal clinic (ANC) in Usmanu Danfodiyo University Teaching Hospital Sokoto. The prevalence and distribution of Rh c and e phenotype was determined among 200 consecutively recruited pregnant women aged 18-45 years and mean age 27.19 ± 4.72 years. Samples were tested for Rh c and e phenotype using the conventional tube agglutination method using Lorne Laboratories (UK) anti c and e antisera. Out of 200 samples studied, the prevalence of Rh c was 92% while Rh e was 98.5%. We observed a statistically significant ethnic variation in the distribution of Rh c and e antigens among the pregnant subjects (p = 0.05 and 0.02) respectively. The prevalence of Rhesus c and e antigens was significantly higher among the Hausa ethnic group compared to the other ethnic groups. A significant number of antenatal attendees were better educated with secondary and tertiary education compared to those with primary and non-formal education. We recommend that all pregnant women in the area be screened for the presence of clinically significant red cell antigens including Rh c and e blood group antigens on their first antenatal visit. There is need to introduce routine alloantibody screening for clinically significant red cell antibodies to facilitate the effective management of anti-c and e related haemolytic disease of the foetus and newborn as well as to prevent haemolytic transfusion reactions. Policy should be developed to facilitate optimum stocking of c and e negative cell in blood bank for emergency use in the area.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Rhesus c and e Phenotype Among Pregnant Women Attending Antenatal Clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto.

Erhabor¹

2016

JGNB

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“…Overall, 2,493 samples from 1,508 pregnant women were tested within the study period. The median Positive, NT Anti-E and anti-C are common alloantibodies among pregnant women [5,13]. In Korea, the prevalence of unexpected antibodies in pregnant women is 1.91%…”

Section: Resultsmentioning

confidence: 99%

Prevalence of Unexpected Antibodies in Pregnant Korean Women and Neonatal Outcomes

Yang

Shin

Song

et al. 2019

KJBT

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Background: In pregnant women, the frequency of irregular antibodies that cause hemolytic disease of the fetus and newborn (HDFN) vary between study populations. The clinical manifestations of HDFN differ according to the specificities and degree of irregular antibodies. This study examined the frequency and nature of maternal alloimmunization and neonatal outcomes. Methods: Pregnant women, who underwent irregular antibody screening for prenatal testing at an obstetrics clinic in a single center, were enrolled. Those who screened positive for irregular antibodies were selected as the test group, and age-and obstetrics history-matched pregnant women were selected as the control group to evaluate the pregnancy outcomes according to irregular antibodies. Results: The prevalence of irregular antibodies was 2.78% (42/1,508). With the exception of an unidentified antibody, anti-D was the most frequently identified antibody, followed in order by anti-E and anti-Le a. The rate of fetal death was higher in the test group (6/37, 16.2%) than in the control group (1/37, 2.7%) (P=0.047). Eight pregnant women had anti-C or anti-D, one woman had a stillbirth, and four living neonates developed hyperbilirubinemia. Of six pregnant women with anti-E alone or with other alloantibodies, three experienced a spontaneous abortion or stillbirth. Among the six newborns with maternal anti-Le a and anti-Jk a , four developed hyperbilirubinemia, but their mothers did not experience a spontaneous abortion or stillbirth. Conclusion: The prevalence of unexpected antibodies among pregnant Korean women was 2.78%. A significant difference in neonatal outcomes was observed, including the death rate, prematurity, and hyperbilirubinemia, depending on the specificity of the unexpected antibody.

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“…Introduction and implementation of RhIG administration over the last few decades have significantly reduced the incidence of anti-D associated HDFN to as low as 0.1%, particularly in developed countries,4 and red cell alloantibodies other than anti-D have now emerged as a major cause of HDFN 2. Prevalence of clinically significant red cell alloimmunization in pregnant females reported in studies from different countries ranges between 0.3% and 3.4% 5–13. In our study, the prevalence of clinically significant red cell alloimmunization was 740 per 100,000 pregnant females (0.74%).…”

Section: Discussionmentioning

confidence: 99%

“…Studies investigating the prevalence of red cell alloantibodies amongst pregnant women have been done in different countries including Croatia, Netherlands, Spain, Nigeria, Norway, Australia, and China 6,8–13. Prevalence of clinically significant red cell alloantibodies has been reported to be anywhere between 0.3% and 3.4% in different studies 5–13. Current practice in the USA recommends red cell antibody screening for all pregnant females at their first prenatal visit.…”

Section: Introductionmentioning

confidence: 99%

<p>Prevalence and specificity of clinically significant red cell alloantibodies in pregnant women - a study from a tertiary care hospital in Southeast Michigan</p>

Moinuddin¹,

Fletcher²,

Millward³

2019

JBM

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BackgroundMaternal red cell IgG antibodies can cross the placenta and cause hemolysis of fetal red cells in case of antigenic differences between maternal and fetal RBCs, leading to hemolytic disease of the fetus and newborn (HDFN). Although the incidence of anti-D associated HDFN has drastically reduced with Rh immune globulin prophylaxis, HDFN due to other maternal red cell alloantibodies still remains a concern. Prevalence and specificities of clinically significant red cell alloantibodies in pregnant females have rarely been reported in the USA.MethodsA retrospective chart review was conducted to determine the prevalence and specificity of clinically significant red cell alloantibodies in pregnant females who delivered at Beaumont Hospital Royal Oak between May 1, 2017 and December 31, 2017. A total of 4548 pregnant females were screened using electronic medical records. One female above 50 years age and two females with invalid ABO type were excluded from the study per IRB approved protocol. The remaining 4545 pregnant females with a valid ABO/RhD type and valid red cell antibody screen were included.ResultsOut of the 4545 included females, 440 had a positive red cell antibody screen. Of these 440 females, 34 had clinically significant alloantibodies, giving an overall prevalence of 0.74%. Anti-E was the most frequently identified significant alloantibody followed by anti-K. The most prevalent significant alloantibodies in RhD positive and RhD negative females were anti-E and anti-K, respectively. Significant association (p-value <0.001) was found between RhD type and the presence of clinically significant alloantibodies amongst females with positive antibody screen.ConclusionOur study aims to reiterate the importance of maternal red cell antibody screening during early pregnancy to help identify and manage high-risk pregnancies. Minimizing the exposure of childbearing age females to incompatible red cell antigens through unnecessary transfusions can help reduce the incidence of red cell alloimmunization and the risk of HDFN.

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Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population

Cited by 17 publications

References 18 publications

Prevalence of Rhesus c and e Phenotype Among Pregnant Women Attending Antenatal Clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto.

Prevalence of Rhesus c and e Phenotype Among Pregnant Women Attending Antenatal Clinic in Usmanu Danfodiyo University Teaching Hospital, Sokoto.

Prevalence of Unexpected Antibodies in Pregnant Korean Women and Neonatal Outcomes

<p>Prevalence and specificity of clinically significant red cell alloantibodies in pregnant women - a study from a tertiary care hospital in Southeast Michigan</p>

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