ABO incompatibility and RhIG immunoprophylaxis protect against non-D alloimmunization by pregnancy
Autor: | Lisa Vermij, Carolien Zwiers, J. M. Koelewijn, C. Ellen van der Schoot, Joost H. J. van Sambeeck, Dick Oepkes, Masja de Haas |
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Přispěvatelé: | Academic Medical Center, Landsteiner Laboratory, Center for Healthcare Operations Improvement and Research |
Jazyk: | angličtina |
Rok vydání: | 2018 |
Předmět: |
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 |
Zdroj: | Transfusion, 58(7), 1611-1617. Wiley-Blackwell |
ISSN: | 0041-1132 |
Popis: | 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. |
Databáze: | OpenAIRE |
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