ArticleBJOG : an international journal of obstetrics and gynaecology2022
Risk factors for RhD immunisation in a high coverage prevention programme of antenatal and postnatal RhIg: a nationwide cohort study.
Article in BJOG : an international journal of obstetrics and gynaecology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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10 citing papers in PubMed, 21 citations in OpenAlex.
- Characterization of the clinical course of early-onset severe hemolytic disease of the fetus and newborn.Pregnancy (Hoboken, N.J.) · 2026Article
- Health Care Use and Recurrence Rate in Hemolytic Disease of the Fetus and Newborn: Retrospective Cohort Study.JMIR pediatrics and parenting · 2026Article
- Prevalence of Alloimmunization and Associated Risk Factors among Antenatal Women in India: A Systematic Review and Meta-Analysis.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2025Review
- IgG-Fc Glycosylation and a Novel Flowcytometric Assay to Predict Hemolytic Disease of the Fetus and Newborn.Transfusion medicine and hemotherapy : offizielles Organ der Deutschen Gesellschaft fur Transfusionsmedizin und Immunhamatologie · 2025Article
- Design of a Phase 3, Global, Multicenter, Randomized, Placebo-Controlled, Double-Blind Study of Nipocalimab in Pregnancies at Risk for Severe Hemolytic Disease of the Fetus and Newborn.American journal of perinatology · 2025Article
- Overview of detection methods of fetomaternal haemorrhage.Frontiers in physiology · 2025Review
- Pregnant women's knowledge and clinical management of hemolytic disease of the fetus and newborn in Pará, Brazil.Hematology, transfusion and cell therapy · 2024Article
- Red Blood Cell Alloimmunization in Pregnancy: A Review of the Pathophysiology, Prevalence, and Risk Factors.Cureus · 2024Review
- 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
- Irregular antibodies in pregnancy during the universal anti-RHD prophylaxis era: a survey of Spanish Hospitals.Blood transfusion = Trasfusione del sangueReview
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Authors and funding
7 authors at 2 institutions in 1 country.
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Abstract
objectiveTo evaluate which risk factors for RhD immunisation remain, despite adequate routine antenatal and postnatal RhIg prophylaxis (1000 IU RhIg) and additional administration of RhIg. The second objective was assessment of the current prevalence of RhD immunisations.
designProspective cohort study.
settingThe Netherlands. POPULATION: Two-year nationwide cohort of alloimmunised RhD-negative women.
methodsRhD-negative women in their first RhD immunised pregnancy were included for risk factor analysis. We compared risk factors for RhD immunisation, occurring either in the previous non-immunised pregnancy or in the index pregnancy, with national population data derived from the Dutch perinatal registration (Perined).
resultsIn the 2-year cohort, data from 193 women were eligible for analysis. Significant risk factors in women previously experiencing a pregnancy of an RhD-positive child (n = 113) were: caesarean section (CS) (OR 1.7, 95% CI 1.1-2.6), perinatal death (OR 3.5, 95% CI 1.1-10.9), gestational age >42 weeks (OR 6.1, 95% CI 2.2-16.6), postnatal bleeding (>1000 ml) (OR 2.0, 95% CI 1.1-3.6), manual removal of the placenta (MRP) (OR 4.3, 95% CI 2.0-9.3); these factors often occurred in combination. The miscarriage rate was significantly higher than in the Dutch population (35% versus 12.-5%, P < 0.001).
conclusionComplicated deliveries, including cases of major bleeding and surgical interventions (CS, MRP), must be recognised as a risk factor, requiring estimation of fetomaternal haemorrhage volume and adjustment of RhIg dosing. The higher miscarriage rate suggests that existing RhIg protocols need adjustment or better compliance. TWEETABLE ABSTRACT: Complicated delivery (caesarean section, manual removal placenta, major bleeding) is the most valid risk factor for RhD immunization despite antenatal and postnatal RhIg.
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