Reduction of anti-K-mediated hemolytic disease of newborns after the introduction of a matched transfusion policy: A nation-wide policy change evaluation study in the Netherlands
| Autor: | Jessie S Luken, Jaap Jan Zwaginga, Johanna G. van der Bom, Mart P. Janssen, Peter C. Ligthart, Henk Schonewille, Claudia C. Folman, Masja de Haas, C. Ellen van der Schoot, Johan H Meekers, Michaël V. Lukens |
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| Přispěvatelé: | Landsteiner Laboratory, Clinical Haematology |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Relative risk reduction
Adult medicine.medical_specialty Erythrocytes Health Planning Guidelines Anemia Transfusion Practice Immunology Population Disease 030204 cardiovascular system & hematology Hemolysis Erythroblastosis Fetal 03 medical and health sciences 0302 clinical medicine Isoantibodies Pregnancy Risk Factors medicine Odds Ratio Immunology and Allergy Humans Blood Transfusion education Netherlands Fetus education.field_of_study business.industry Obstetrics Kell Blood-Group System Infant Newborn Hematology Guideline Odds ratio medicine.disease Policy Blood Group Incompatibility Female business 030215 immunology |
| Zdroj: | Transfusion, 1-9. Wiley STARTPAGE=1;ENDPAGE=9;ISSN=0041-1132;TITLE=Transfusion Transfusion, 61(3), 713-721. WILEY Transfusion Transfusion, 61(3), 713-721. Wiley-Blackwell |
| ISSN: | 0041-1132 |
| Popis: | Background: During pregnancy, maternal red blood cell (RBC) antibodies can lead to life-threatening fetal hemolysis and anemia. Women can become immunized by a pregnancy or an unmatched transfusion. Our aim was to quantify the effect of a nationwide K-matched transfusion policy for women of childbearing age potential to prevent K-immunization in pregnancy.Study Design and Methods: In this nation-wide policy change evaluation study we determined the occurrence of RBC antibodies before and after introduction of a K-matched transfusion policy and evaluated the cause K alloimmunization 10 years after introduction of this measure. K-matched transfusion for females under 45 years of age is advised in the Dutch transfusion guideline since 2004. We used laboratory data from pregnancies with RBC antibodies identified in the period 1999-2018 obtained as part of a population-based screening program in the Netherlands.Results: Tests of 36 286 pregnancies produced a positive antibody screening result which concerned anti-K in 1550 pregnancies. The occurrence of anti-K decreased from 67.9 to 20.2 per 100 000 pregnancies. The relative risk reduction was 0.70 which largely exceeded the relative risk reduction of 0.27 for antibodies against RBC antigens for which no preventive matching is required. The number of pregnancies at risk for anti-K-mediated disease decreased from 9.7 to 4.2 per 100 000 pregnancies.Conclusions: A K-matched transfusion policy is associated with a major decrease in a number of pregnant women with anti-K and pregnancies at risk for anti-K-mediated disease. A relatively simple measure is now shown to impact prevention of hemolytic disease in the fetus and newborn. |
| Databáze: | OpenAIRE |
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