Evidence map›Paper›PMID 42028161›Full record

ArticleAJOG global reports2026

Adverse perinatal outcomes indicative of RhD-mediated hemolytic disease of the fetus and newborn in Eastern Ethiopia: evidence of maternal health inequity in a multicenter cohort study.

Assefa Desalew, C Ellen van der Schoot, Rafiki N Mjema, Thomas van den Akker, Tienke Vermeiden, Henk Schonewille, Jeremia J Pyuza, Tadesse Gure, E J T Joanne Verweij, Abera Kenay Tura

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Article in AJOG global reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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10 authors.

Assefa DesalewDepartment of Pediatric and Child Health Nursing, School of Nursing, College of Health and Medical Sciences (Desalew, Tura), Haramaya University, Harar, Ethiopia.
C Ellen van der SchootDepartment of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (van der Schoot, Schonewille), University of Amsterdam, Amsterdam, the Netherlands.
Rafiki N MjemaDepartment of Obstetrics and Gynecology (Desalew, Mjema, van den Akker, Vermeiden, Verweij), Leiden University Medical Centre, Leiden University, the Netherlands.
Thomas van den AkkerDepartment of Obstetrics and Gynecology (Desalew, Mjema, van den Akker, Vermeiden, Verweij), Leiden University Medical Centre, Leiden University, the Netherlands.
Tienke VermeidenDepartment of Obstetrics and Gynecology (Desalew, Mjema, van den Akker, Vermeiden, Verweij), Leiden University Medical Centre, Leiden University, the Netherlands.
Henk SchonewilleDepartment of Experimental Immunohematology, Sanquin Research and Landsteiner Laboratory, Academic Medical Center (van der Schoot, Schonewille), University of Amsterdam, Amsterdam, the Netherlands.
Jeremia J PyuzaDepartment of Pathology (Pyuza), Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Tadesse GureDepartment of Obstetrics and Gynecology, College of Health and Medical Sciences (Gure), Haramaya University, Harar, Ethiopia.
E J T Joanne VerweijDepartment of Obstetrics and Gynecology (Desalew, Mjema, van den Akker, Vermeiden, Verweij), Leiden University Medical Centre, Leiden University, the Netherlands.
Abera Kenay TuraDepartment of Pediatric and Child Health Nursing, School of Nursing, College of Health and Medical Sciences (Desalew, Tura), Haramaya University, Harar, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAlthough hemolytic disease of the fetus and newborn (HDFN) has become rare in high-income countries, it remains a significant cause of perinatal death in low-and middle-income countries. Nonetheless, true epidemiological data in Africa are lacking.

objectiveTo obtain insight into the prevalence of anti-Rhesus D-mediated HDFN in Ethiopia, pregnancy outcomes were compared between RhD-negative and RhD-positive women. STUDY

designA multicenter facility-based retrospective cohort study was performed on 6796 women who gave birth (≥28 weeks of gestation) in 13 Ethiopian Obstetric Surveillance System hospitals from January to March 2024. Data were retrospectively collected from maternal and neonatal medical records from antenatal care to birth and neonatal registry. The composite adverse perinatal outcomes (APO) included stillbirth, neonatal loss, or Neonatal Intensive Care Unit admission. The likelihood of HDFN was based on clinical review by 3 experts blinded to the maternal blood group.

resultsIn 6141 of 6796 women with known RhD status, 327 (5.3%) were RhD-negative. APO was seen in 13.3% women, and occurred twice as often in RhD-negative, as compared to RhD-positive women (aOR=2.3; 95% CI: 1.7-2.9). Clinical signs were highly suggestive of HDFN in 5.8% of RhD-negative women, as compared to 0.2% in RhD-positive women (

conclusionOur study identifies that RhD-negative women experience a two-fold increased odds of APO, most likely due to HDFN. This highlights the need for strategies to address these maternal and child health inequities, including using anti-RhD immunoprophylaxis to prevent HDFN and screening for blood group antibodies to identify pregnancies at risk.

Indexed as

EthiopiaHealth inequityHemolytic disease of the fetus and newbornLow and middle-income countriesRhD blood groupRh diseaseRisk pregnancy

Identifiers

PMID42028161
PMCPMC13101771

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