TY - JOUR
T1 - Red blood cell alloimmunization prevalence and hemolytic disease of the fetus and newborn in Israel
T2 - A retrospective study
AU - Rahimi-Levene, Naomi
AU - Chezar, Judith
AU - Yahalom, Vered
AU - Abed-Alenbi, Assad
AU - Akira, Luiza
AU - Arbov, Leah
AU - Asher, Orna
AU - Barshai, Yosef
AU - Bonstein, Lilach
AU - Chubar, Evgeni
AU - Dally, Najib
AU - Dann, Eldad J.
AU - Ellis, Martin
AU - Feldman, Lilia
AU - Fleischer, Stela
AU - Glick, Yossi
AU - Gural, Alex
AU - Hareuveni, Mara
AU - Kirschner, Ilya
AU - Kodakin, Vera
AU - Naamad, Mira
AU - Peer, Victoria
AU - Peled, Hagit
AU - Pikovski, Oleg
AU - Shalev, Bruria
AU - Shaoul, Ety
AU - Shabad, Evelyn
AU - Sharon, Yehudit
AU - Shinar, Eilat
AU - Sigler, Erica
AU - Yaacobi, Golda
AU - Zelig, Orly
AU - Zivony, Yifat T.
N1 - Publisher Copyright: © 2020 AABB
PY - 2020/11
Y1 - 2020/11
N2 - Hemolytic disease of the fetus and newborn (HDFN) is a severe form of anemia caused by maternal antibodies against fetal red blood cells (RBC) that can cause intrauterine and perinatal morbidity and mortality. The prevalence and specificities of alloantibodies among Israeli pregnant women and clinical outcomes for their fetuses and newborns are unknown. Study Design and Methods: A retrospective study of women who gave birth between January 1, 2011, and December 31, 2011, was performed. Data were obtained for obstetric admissions from 16 of 27 hospitals, which included results of maternal ABO, D, antibody screens, antibody identification, and requirements for intrauterine or newborn exchange transfusions. Results: Data on 90 948 women representing 70% of all births during 2011 were analyzed. Antibody screen was positive in 5245 (5.8%) women. Alloantibodies, excluding anti-D titer (<16) were identified in 900 (1.0%) women. Of 191 D– women, 75 (39.3%) had anti-D titer of 16 or greater. Other common clinically significant antibodies were anti-E (204, 23%), anti-K (145, 16%), and anti-c (97, 10.8%) alone or in antibody combinations. Multiple alloantibodies were observed in 132 of 900 (15%) of women. Severe HDFN developed in 6.8% (9/132) of these pregnancies. Seventeen fetuses and newborns (0.02% of births) including one set of twins required RBC transfusions. Two fetuses whose mothers had multiple alloantibodies received intrauterine transfusions; one of them was hydropic and died. Conclusion: The prevalence of RBC alloantibodies was 1.0% among Israeli pregnant women. Transfusion was required in 0.02% of the fetuses and newborns. Severe HDFN developed in 6.8% of pregnancies with multiple maternal alloantibodies.
AB - Hemolytic disease of the fetus and newborn (HDFN) is a severe form of anemia caused by maternal antibodies against fetal red blood cells (RBC) that can cause intrauterine and perinatal morbidity and mortality. The prevalence and specificities of alloantibodies among Israeli pregnant women and clinical outcomes for their fetuses and newborns are unknown. Study Design and Methods: A retrospective study of women who gave birth between January 1, 2011, and December 31, 2011, was performed. Data were obtained for obstetric admissions from 16 of 27 hospitals, which included results of maternal ABO, D, antibody screens, antibody identification, and requirements for intrauterine or newborn exchange transfusions. Results: Data on 90 948 women representing 70% of all births during 2011 were analyzed. Antibody screen was positive in 5245 (5.8%) women. Alloantibodies, excluding anti-D titer (<16) were identified in 900 (1.0%) women. Of 191 D– women, 75 (39.3%) had anti-D titer of 16 or greater. Other common clinically significant antibodies were anti-E (204, 23%), anti-K (145, 16%), and anti-c (97, 10.8%) alone or in antibody combinations. Multiple alloantibodies were observed in 132 of 900 (15%) of women. Severe HDFN developed in 6.8% (9/132) of these pregnancies. Seventeen fetuses and newborns (0.02% of births) including one set of twins required RBC transfusions. Two fetuses whose mothers had multiple alloantibodies received intrauterine transfusions; one of them was hydropic and died. Conclusion: The prevalence of RBC alloantibodies was 1.0% among Israeli pregnant women. Transfusion was required in 0.02% of the fetuses and newborns. Severe HDFN developed in 6.8% of pregnancies with multiple maternal alloantibodies.
KW - Adult
KW - Blood Transfusion, Intrauterine/adverse effects
KW - Erythroblastosis, Fetal/blood
KW - Erythrocyte Transfusion/adverse effects
KW - Female
KW - Humans
KW - Infant, Newborn
KW - Israel/epidemiology
KW - Pregnancy
KW - Prevalence
KW - Retrospective Studies
KW - Rho(D) Immune Globulin/blood
KW - Transfusion Reaction/blood
UR - http://www.scopus.com/inward/record.url?scp=85089105197&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/trf.15987
DO - https://doi.org/10.1111/trf.15987
M3 - مقالة
C2 - 32770778
SN - 0041-1132
VL - 60
SP - 2684
EP - 2690
JO - Transfusion
JF - Transfusion
IS - 11
ER -