Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective study

Background: Transplacental-derived anti-D IgG in RhD-negative pregnant women can trigger an immune response to Rh D-positive red cells in fetuses and newborns. We assessed the effect of anti-D titers in RhD-negative pregnant women on fetuses and newborns. Methods: The clinical data of 142 singleton...

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Main Authors: Tong-Hui Tang, Chu-Yi Guo, Xiao-Yu Li, Yi-Xin Hu, Wang-Kai Liu, Mu-Xue Yu
Format: Article
Language:English
Published: Elsevier 2024-05-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957223002061
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author Tong-Hui Tang
Chu-Yi Guo
Xiao-Yu Li
Yi-Xin Hu
Wang-Kai Liu
Mu-Xue Yu
author_facet Tong-Hui Tang
Chu-Yi Guo
Xiao-Yu Li
Yi-Xin Hu
Wang-Kai Liu
Mu-Xue Yu
author_sort Tong-Hui Tang
collection DOAJ
description Background: Transplacental-derived anti-D IgG in RhD-negative pregnant women can trigger an immune response to Rh D-positive red cells in fetuses and newborns. We assessed the effect of anti-D titers in RhD-negative pregnant women on fetuses and newborns. Methods: The clinical data of 142 singleton RhD-sensitized pregnancies were retrospectively collected. The pregnant women received routine prenatal care and the newborns had standard care. Based on the tertile categories of the pregnancies, the maximum titers of anti-D IgG in the pregnant women were divided into three groups ranging from low to high as follows: low-titer group (anti-D titer: 1:4–1:128, n = 57); medium-titer group (anti-D titer: 1:256–1:512, n = 50); and high-titer group (anti-D titer: 1:1024–1:4096, n = 35). Results: The frequencies of major neonatal complications did not significantly differ among the three groups. The high-titer group had the highest frequency of pregnancies requiring intrauterine transfusion (IUT) and number of IUTs among the three groups. The high-titer group had a significantly higher frequency of newborns treated with top-up transfusion, number of top-up transfusions, frequency of newborns treated with exchange transfusion (ET), and number of ETs when compared to the low-titer group. Conclusion: Higher anti-D titers in RhD-negative pregnant women predict more severe fetal and neonatal hemolytic anemia. Increasing maternal anti-D titers results in an increased need for IUTs, and neonatal top-up transfusions and ETs. Methods for reducing titers of anti-D IgG in RhD-sensitized pregnant women warrants further investigation.
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spelling doaj-art-2deb07419f7d4b67b0a52558189451a92025-08-20T02:01:40ZengElsevierPediatrics and Neonatology1875-95722024-05-0165328829210.1016/j.pedneo.2023.03.015Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective studyTong-Hui Tang0Chu-Yi Guo1Xiao-Yu Li2Yi-Xin Hu3Wang-Kai Liu4Mu-Xue Yu5Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, ChinaDepartment of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, ChinaDepartment of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, ChinaDepartment of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, ChinaCorresponding author. The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China.; Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, ChinaCorresponding author. The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road 2, Guangzhou, Guangdong, 510080, China.; Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, 510080, ChinaBackground: Transplacental-derived anti-D IgG in RhD-negative pregnant women can trigger an immune response to Rh D-positive red cells in fetuses and newborns. We assessed the effect of anti-D titers in RhD-negative pregnant women on fetuses and newborns. Methods: The clinical data of 142 singleton RhD-sensitized pregnancies were retrospectively collected. The pregnant women received routine prenatal care and the newborns had standard care. Based on the tertile categories of the pregnancies, the maximum titers of anti-D IgG in the pregnant women were divided into three groups ranging from low to high as follows: low-titer group (anti-D titer: 1:4–1:128, n = 57); medium-titer group (anti-D titer: 1:256–1:512, n = 50); and high-titer group (anti-D titer: 1:1024–1:4096, n = 35). Results: The frequencies of major neonatal complications did not significantly differ among the three groups. The high-titer group had the highest frequency of pregnancies requiring intrauterine transfusion (IUT) and number of IUTs among the three groups. The high-titer group had a significantly higher frequency of newborns treated with top-up transfusion, number of top-up transfusions, frequency of newborns treated with exchange transfusion (ET), and number of ETs when compared to the low-titer group. Conclusion: Higher anti-D titers in RhD-negative pregnant women predict more severe fetal and neonatal hemolytic anemia. Increasing maternal anti-D titers results in an increased need for IUTs, and neonatal top-up transfusions and ETs. Methods for reducing titers of anti-D IgG in RhD-sensitized pregnant women warrants further investigation.http://www.sciencedirect.com/science/article/pii/S1875957223002061Anti-D titersHemolytic anemiaPregnancyRh-negative
spellingShingle Tong-Hui Tang
Chu-Yi Guo
Xiao-Yu Li
Yi-Xin Hu
Wang-Kai Liu
Mu-Xue Yu
Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective study
Pediatrics and Neonatology
Anti-D titers
Hemolytic anemia
Pregnancy
Rh-negative
title Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective study
title_full Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective study
title_fullStr Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective study
title_full_unstemmed Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective study
title_short Effect of Anti-D titers in RhD-negative pregnant women on fetuses and newborns: A retrospective study
title_sort effect of anti d titers in rhd negative pregnant women on fetuses and newborns a retrospective study
topic Anti-D titers
Hemolytic anemia
Pregnancy
Rh-negative
url http://www.sciencedirect.com/science/article/pii/S1875957223002061
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