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ABO incompatibility and RhIG immunoprophylaxis protect against non-D alloimmunization by pregnancy
- Source :
- Transfusion, 58(7), 1611-1617. Wiley-Blackwell
- Publication Year :
- 2018
-
Abstract
- Background Hemolytic disease of the fetus and newborn (HDFN) is caused by maternal antibodies against fetal red blood cell antigens, most often anti-D, -K, or -c. ABO incompatibility between mother and child and anti-D immunoprophylaxis (RhIG) are known to reduce the risk of D immunization and subsequent HDFN. However, no immunoprophylaxis has been developed to prevent non-D immunizations. Study design and methods We evaluated whether ABO incompatibility has a preventive effect on formation of non-D alloantibodies, by performing a case-control study including pregnant women with newly detected non-D antibodies, identified within a nationwide data set, immunized during their first pregnancy and/or delivery. Subsequently, we assessed a possible protective effect of RhIG in a subgroup with non-Rh antibodies only. The proportions of previous ABO incompatibility and of RhIG administrations of these women were compared to the known rate of 19.4% ABO incompatibility and 9.9% RhIG administrations (D- women carrying a D+ child) in the general population of pregnant women. Results A total of 11.9% of the 232 included immunized women had a possible ABO incompatibility in their first pregnancy (vs. expected 19.4%; 95% confidence interval [CI], 7.3-18.8; p = 0.036). Furthermore, 1.0% women with non-Rh antibodies were D-, delivered a D+ child, and had therefore received RhIG, whereas 9.9% was expected (95% CI, 0.18-5.50; p = 0.003). Conclusion We found that ABO incompatibility and RhIG reduce the risks not only for D, but also for non-Rh immunizations, suggesting that antibody-mediated immune suppression in this condition is not antigen specific.
- Subjects :
- Adult
medicine.medical_specialty
Rho(D) Immune Globulin
Immunology
Population
UT-Hybrid-D
030204 cardiovascular system & hematology
Immunoprophylaxis
ABO incompatibility
ABO Blood-Group System
03 medical and health sciences
0302 clinical medicine
Immune system
Antigen
Isoantibodies
Pregnancy
medicine
Humans
Immunology and Allergy
education
Fetus
education.field_of_study
biology
Hemolytic disease of the fetus and newborn
Obstetrics
business.industry
Case-control study
Hematology
medicine.disease
n/a OA procedure
Immunization
Blood Group Incompatibility
Case-Control Studies
biology.protein
Female
Antibody
business
030215 immunology
Subjects
Details
- Language :
- English
- ISSN :
- 00411132
- Database :
- OpenAIRE
- Journal :
- Transfusion, 58(7), 1611-1617. Wiley-Blackwell
- Accession number :
- edsair.doi.dedup.....35d5c325b675e2a70d495cbdb380aa11