دورية أكاديمية
Neonatal and Obstetrical Outcomes of Pregnancies Complicated by Alloimmunization.
| العنوان: | Neonatal and Obstetrical Outcomes of Pregnancies Complicated by Alloimmunization. |
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| المؤلفون: | Bahr TM; Obstetric and Neonatal Operations.; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah., Tweddell SM; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah., Zalla JM; Obstetric and Neonatal Operations., Dizon-Townson D; Maternal-Fetal Medicine, Intermountain Health, Salt Lake City, Utah., Ohls RK; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah., Henry E; Obstetric and Neonatal Operations., Ilstrup SJ; Intermountain Health Transfusion Services and Department of Pathology, Intermountain Medical Center, Murray, Utah., Kelley WE; American National Red Cross, Salt Lake City, Utah.; Department of Pathology, University of Arizona College of Medicine, Tucson, Arizona., Ling CY; Obstetric and Neonatal Operations.; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah., Lindgren PC; Obstetric and Neonatal Operations., O'Brien EA; Obstetric and Neonatal Operations.; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah., Christensen RD; Obstetric and Neonatal Operations.; Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, Utah. |
| المصدر: | Pediatrics [Pediatrics] 2024 Jun 01; Vol. 153 (6). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Academy of Pediatrics Country of Publication: United States NLM ID: 0376422 Publication Model: Print Cited Medium: Internet ISSN: 1098-4275 (Electronic) Linking ISSN: 00314005 NLM ISO Abbreviation: Pediatrics Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Elk Grove Village Il : American Academy of Pediatrics Original Publication: Springfield, Ill., Thomas. |
| مواضيع طبية MeSH: | Isoantibodies*/immunology , Isoantibodies*/blood , Rh Isoimmunization*/immunology , Rh Isoimmunization*/epidemiology , Erythroblastosis, Fetal*/immunology , Erythroblastosis, Fetal*/epidemiology , Erythroblastosis, Fetal*/diagnosis, Humans ; Female ; Pregnancy ; Infant, Newborn ; Pregnancy Outcome/epidemiology ; Rh-Hr Blood-Group System/immunology ; Male ; Rho(D) Immune Globulin/immunology ; Adult ; Retrospective Studies |
| مستخلص: | Background and Objectives: Despite advances in the prevention of rhesus (Rh)(D) alloimmunization, alloantibodies to Rh(D) and non-Rh(D) red blood cell antigens continue to be detected in ∼4% of US pregnancies and can result in hemolytic disease of the fetus and newborn (HDFN). Recent reports on HDFN lack granularity and are unable to provide antibody-specific outcomes. The objective of this study was to calculate the frequency of alloimmunization in our large hospital system and summarize the outcomes based on antibody specificity, titer, and other clinical factors. Methods: We identified all births in a 6-year period after a positive red blood cell antibody screen result during pregnancy and summarized their characteristics and outcomes. Results: A total of 707 neonates were born after a positive maternal antibody screen result (3.0/1000 live births). In 31 (4%), the positive screen result was due to rhesus immune globulin alone. Of the 676 neonates exposed to alloantibodies, the direct antibody test (DAT) result was positive, showing antigen-positivity and evidence of HDFN in 37% of those tested. Neonatal disease was most severe with DAT-positive anti-Rh antibodies (c, C, D, e, E). All neonatal red blood cell transfusions (15) and exchange transfusions (6) were due to anti-Rh alloimmunization. No neonates born to mothers with anti-M, anti-S, anti-Duffy, anti-Kidd A, or anti-Lewis required NICU admission for hyperbilirubinemia or transfusion. Conclusions: Alloimmunization to Rh-group antibodies continues to cause a majority of the severe HDFN cases in our hospital system. In neonates born to alloimmunized mothers, a positive DAT result revealing antigen-positivity is the best predictor of anemia and hyperbilirubinemia. (Copyright © 2024 by the American Academy of Pediatrics.) |
| المشرفين على المادة: | 0 (Isoantibodies) 0 (Rh-Hr Blood-Group System) 0 (Rho(D) Immune Globulin) |
| تواريخ الأحداث: | Date Created: 20240524 Date Completed: 20240531 Latest Revision: 20240531 |
| رمز التحديث: | 20240601 |
| DOI: | 10.1542/peds.2023-064604 |
| PMID: | 38784990 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1098-4275 |
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| DOI: | 10.1542/peds.2023-064604 |