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

Abstract

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.

Prevalence, Specificity and Titration of Red Cell Alloantibodies in Multiparous Antenatal Females at a Tertiary Care Centre from North India

“…Alloimmunization rates in antenatal females ranged from 0.4 to 2.71 % [8][9][10][11][12][13][14][15][16].…”

Urgent global opportunities to prevent birth defects

“…Lacking prophylaxis, it is estimated that at least one in every six RhD-negative women delivering an RhD-positive baby would be at risk [53]. To understand the racial distribution of this burden, w15% of Caucasians, 3e5% of African-Americans, 8% Asian-Indians, and <1% of Asians have RhDnegative blood groups [50,54,55]. The prevalence of RhD-negative blood group in Europeans is relatively high, and varies between 11% and 21%.…”

Prevalence of “unexpected antibodies” in the antenatal women attending the Government Maternity Hospital, Tirupati

“…Out of 2060 mothers, history of blood transfusion was present in 14 (0.7%) women but none had alloantibodies. Prevalence of alloimmunization among pregnant women documented in various published studies [8][9][10][13][14][15][16] and the present study is shown in Table 6.…”