ArticleBJOG : an international journal of obstetrics and gynaecology2009
Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis.
Article in BJOG : an international journal of obstetrics and gynaecology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 67 citations in OpenAlex.
- Mild-to-moderate foeto-maternal haemorrhage in the third trimester and at term of pregnancy: quantitative determination and clinical-diagnostic evaluation.Blood transfusion = Trasfusione del sangue · 2018Trial
- The importance of antenatal prevention of RhD immunisation in the first pregnancy.Blood transfusion = Trasfusione del sangue · 2014Trial
- Implementing non-invasive RHD genotyping on cell-free foetal DNA from maternal plasma: the Pavia experience.Blood transfusion = Trasfusione del sangue · 2012Trial
- Persistence of antenatal anti-D immunoglobulin G at delivery in twin versus singleton pregnancies: a retrospective cohort study.BMC pregnancy and childbirth · 2026Article
- Hemolytic Disease of the Fetus and Newborn in an Integrated Health Care System.American journal of perinatology · 2025Article
- Laboratory assessment of fetomaternal haemorrhage and Rh immune globulin management: Canadian practice and scoping review.British journal of haematology · 2025Article
- Clinical characteristics and outcomes of pregnancies at-risk of hemolytic disease of the fetus and newborn in Sweden, Finland, and Denmark: a population-based register study.AJOG global reports · 2025Article
- Magnitude of Red Blood Cell Alloimmunization Among Pregnant Women Attending Antenatal Care at Wolaita Sodo University Comprehensive Specialized Hospital, Southwest Ethiopia.Journal of blood medicine · 2023Article
- Risk factors for RhD immunisation in a high coverage prevention programme of antenatal and postnatal RhIg: a nationwide cohort study.BJOG : an international journal of obstetrics and gynaecology · 2022Article
- Following targeted routine antenatal anti-D prophylaxis, almost half of the pregnant women had undetectable anti-D prophylaxis at delivery.Acta obstetricia et gynecologica Scandinavica · 2022Observational
- Antibodies against human neutrophil antigens in non-transfused women with red blood cell alloimmunisation induced by pregnancy.Blood transfusion = Trasfusione del sangue · 2021Article
- Prevalence of rhesus D-negative blood type and the challenges of rhesus D immunoprophylaxis among obstetric population in Ethiopia: a systematic review and meta-analysis.Maternal health, neonatology and perinatology · 2021Review
- Severe haemolytic disease of a newborn with variant D mimicking blocked-D phenomenon.BMJ case reports · 2019Article
- Predicting anti-RhD titers in donors: Boostering response and decline rates are personal.PloS one · 2018Article
- Rare problems with RhD immunoglobulin for postnatal prophylaxis after large fetomaternal haemorrhage.Obstetric medicine · 2015Article
- Assessment of feto-maternal hemorrhage among rhesus D negative pregnant mothers using the kleihauer-betke test (KBT) and flow cytometry (FCM) in Addis Ababa, Ethiopia.BMC pregnancy and childbirth · 2014Article
- Observational
- The challenges of meeting the blood transfusion requirements in Sub-Saharan Africa: the need for the development of alternatives to allogenic blood.Journal of blood medicine · 2011Article
- Rh isoimmunization in Sub-Saharan Africa indicates need for universal access to anti-RhD immunoglobulin and effective management of D-negative pregnancies.International journal of women's health · 2010Article
- Red blood cell alloimmunization among rhesus D-negative patients in a teaching hospital in Northeastern Malaysia.Asian journal of transfusion scienceArticle
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify risk factors for Rhesus D (RhD) immunisation in pregnancy, despite adequate antenatal and postnatal anti-D prophylaxis in the previous pregnancy. To generate evidence for improved primary prevention by extra administration of anti-D Ig in the presence of a risk factor.
designCase-control study.
settingNation-wide evaluation of the Dutch antenatal anti-D-prophylaxis programme. POPULATION: CASES: 42 RhD-immunised parae-1, recognised by first-trimester routine red cell antibody screening in their current pregnancy, who received antenatal and postnatal anti-D Ig prophylaxis (gifts of 1000 iu) in their first pregnancy. CONTROLS: 339 parae-1 without red cell antibodies.
methodsData were collected via obstetric care workers and/or personal interviews with women.
main outcome measureSignificant risk factors for RhD immunisation in multivariate analysis.
resultsIndependent risk factors were non-spontaneous delivery (assisted vaginal delivery or caesarean section) (OR 2.23; 95% CI:1.04-4.74), postmaturity (>or=42 weeks of completed gestation: OR 3.07; 95% CI:1.02-9.02), pregnancy-related red blood cell transfusion (OR 3.51; 95% CI:0.97-12.7 and age (OR 0.89/year; 95% CI:0.80-0.98). In 43% of cases, none of the categorical risk factors was present.
conclusionsIn at least half of the failures of anti-D Ig prophylaxis, a condition related to increased fetomaternal haemorrhage (FMH) and/or insufficient anti-D Ig levels was observed. Hence, RhD immunisation may be further reduced by strict compliance to guidelines concerning determination of FMH and accordingly adjusted anti-D Ig prophylaxis, or by routine administration of extra anti-D Ig after a non-spontaneous delivery and/or a complicated or prolonged third stage of labour.
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