Time points and risk factors for RhD immunizations after the implementation of targeted routine antenatal anti-D prophylaxis:a retrospective nationwide cohort study
| Autor: | Malla Kuosmanen, Marja Vääräsmäki, Maija Riitta Ordén, Kati Sulin, Katri Haimila, Susanna Sainio, Suvi Toivonen, Kaarin Mäkikallio-Anttila, Riina M. Jernman, Kati Tihtonen, Camilla Isaksson |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty Time Factors anti-D Rho(D) Immune Globulin Population Rh Isoimmunization immunization Cohort Studies prevention Pregnancy Risk Factors medicine Anti d prophylaxis Humans risk factors education routine antenatal anti-D prophylaxis Finland Retrospective Studies education.field_of_study Rh-Hr Blood-Group System business.industry Obstetrics Incidence (epidemiology) Incidence Pregnancy Complications Hematologic Obstetrics and Gynecology Retrospective cohort study Prenatal Care General Medicine medicine.disease Rhesus d 3. Good health fetomaternal hemorrhage Gestation Female business Cohort study |
| Popis: | Background: Targeted routine antenatal anti-D prophylaxis was introduced to the national prophylaxis program in Finland in late 2013. The aim of this study was to assess the incidence, time-points, and risk factors for Rhesus D immunization after the implementation of routine antenatal anti-D prophylaxis, in all women in Finland with antenatal anti-D antibodies detected in 2014–2017. Material and methods: In a nationwide population-based retrospective cohort study, the incidence, time-points, and risk factors of anti-D immunizations were analyzed. Information on antenatal screening was obtained from the Finnish Red Cross Blood Service database, and obstetric data from hospital records and the Finnish Medical Birth Register. Results: The study included a total of 228 women (197 with complete data for all pregnancies). After the implementation of routine antenatal anti-D prophylaxis, the prevalence of pregnancies with anti-D antibodies decreased from 1.52% in 2014 to 0.88% in 2017, and the corresponding incidence of new immunizations decreased from 0.33% to 0.10%. Time-points for detection of new anti-D antibodies before and after 2014 were the first screening sample at 8–12 weeks of gestation in 52% vs 19%, the second sample at 24–26 weeks in 20% vs 50%, and the third screening at 36 weeks in 28% vs 32%. Conclusions: The incidence of new anti-D immunizations decreased as expected after the implementation of routine antenatal anti-D prophylaxis. True failures are rare and they mainly occur when the prophylaxis is not given appropriately, suggesting a need for constant education of healthcare professionals on the subject. |
| Databáze: | OpenAIRE |
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