Observational studyPloS one2013
Targeted routine antenatal anti-D prophylaxis in the prevention of RhD immunisation--outcome of a new antenatal screening and prevention program.
Observational study in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Antenatal and postpartum prevention of Rh alloimmunization: A systematic review and GRADE analysis.PloS one · 2020Pooled it
- Prenatal non-invasive foetal RHD genotyping: diagnostic accuracy of a test as a guide for appropriate administration of antenatal anti-D immunoprophylaxis.Blood transfusion = Trasfusione del sangue · 2018Trial
- Understanding the consequences of being RhD immunized during pregnancy 10 years after introduction of targeted routine antenatal anti-D prophylaxis: A retrospective nationwide cohort study.Acta obstetricia et gynecologica Scandinavica · 2026Article
- Routine use of a spike-in DNA in-process control for foetal RHD genotyping: Testing the real-world effectiveness of this 'canary'.Vox sanguinis · 2026Article
- Noninvasive fetal blood group antigen genotyping.Blood transfusion = Trasfusione del sangue · 2025Review
- Evaluation of an automated platform for non-invasive single-exon fetal RHD genotyping early in pregnancy.Blood transfusion = Trasfusione del sangue · 2023Article
- Prevalence and determinants of RH alloimmunization in Rh-negative women in teaching hospitals of Addis Ababa, Ethiopia: a hospital-based cross-sectional study.Frontiers in global women's health · 2023Article
- Single-exon approach to non-invasive fetal RHD screening in early pregnancy: An update after 10 years' experience.Vox sanguinis · 2022Article
- 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
- Assessment of Fetal Rhesus D and Gender with Cell-Free DNA and Exosomes from Maternal Blood.Reproductive sciences (Thousand Oaks, Calif.) · 2021Article
- Noninvasive Fetal RhD Blood Group Genotyping: A Health Technology Assessment.Ontario health technology assessment series · 2020Review
- Effects of RHD gene polymorphisms on distinguishing weak D or DEL from RhD- in blood donation in a Chinese population.Molecular genetics & genomic medicine · 2019Article
- Anti-Human Platelet Antigen-1a Immunoglobulin G Preparation Intended to Prevent Fetal and Neonatal Alloimmune Thrombocytopenia.PloS one · 2016Article
- Genome-Wide Sequencing for Prenatal Detection of Fetal Single-Gene Disorders.Cold Spring Harbor perspectives in medicine · 2015Review
- Fetal RHD Genotyping Using Real-Time Polymerase Chain Reaction Analysis of Cell-Free Fetal DNA in Pregnancy of RhD Negative Women in South of Iran.International journal of fertility & sterilityArticle
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo estimate the incidence of RhD immunisation after implementation of first trimester non-invasive fetal RHD screening to select only RhD negative women carrying RHD positive fetuses for routine antenatal anti-D prophylaxis (RAADP). MATERIALS AND
methodsWe present a population-based prospective observational cohort study with historic controls including all maternity care centres and delivery hospitals in the Stockholm region, Sweden. All RhD negative pregnant women were screened for fetal RHD genotype in the first trimester of pregnancy. Anti-D immunoglobulin (250-300 µg) was administered intramuscularly in gestational week 28-30 to participants with RHD positive fetuses. Main outcome measure was the incidence of RhD immunisation developing during or after pregnancy.
resultsDuring the study period 9380 RhD negative women gave birth in Stockholm. Non-invasive fetal RHD genotyping using cell-free fetal DNA in maternal plasma was performed in 8374 pregnancies of which 5104 (61%) were RHD positive and 3270 (39%) RHD negative. In 4590 pregnancies with an RHD positive test the women received antenatal anti-D prophylaxis. The incidence of RhD immunisation in the study cohort was 0.26 percent (24/9380) (95% CI 0.15-0.36%) compared to 0.46 percent (86/18546) (95% CI 0.37 to 0.56%) in the reference cohort. The risk ratio (RR) for sensitisation was 0.55 (95% CI 0.35 to 0.87) and the risk reduction was statistically significant (p = 0.009). The absolute risk difference was 0.20 percent, corresponding to a number needed to treat (NNT) of 500.
conclusionsUsing first trimester non-invasive antenatal screening for fetal RHD to target routine antenatal anti-D prophylaxis selectively to RhD negative women with RHD positive fetuses significantly reduces the incidence of new RhD immunisation. The risk reduction is comparable to that reported in studies evaluating the outcome of non selective RAADP to all RhD negative women. The cost-effectiveness of this targeted approach remains to be studied.
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