Study on red blood cell alloantibodies detection in malay women during pregnancy
Pregnancy is known to cause red blood cell (RBC) alloimmunisation which may lead to the production of harmful alloantibodies and subsequently potentially to cause haemolytic disease of fetal and newborn (HDFN). However, RBC alloantibodies are significantly different between different populations...
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| Main Author: | |
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| Format: | Monograph |
| Language: | English |
| Published: |
Pusat Pengajian Sains Perubatan
2013
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| Subjects: | |
| Online Access: | http://eprints.usm.my/54919/1/MADYA%20SHAH%20REZA%20JOHAN%20NOOR%20-%20e.pdf http://eprints.usm.my/54919/ |
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| Summary: | Pregnancy is known to cause red blood cell (RBC) alloimmunisation which may lead to
the production of harmful alloantibodies and subsequently potentially to cause haemolytic
disease of fetal and newborn (HDFN). However, RBC alloantibodies are significantly
different between different populations and ethnics. Aim of this study is to determine the
prevalence of RBC alloantibody among Malay pregnant women and its association with
HDFN.
Clinical and serological data of 5163 Malay pregnant women who attended labour room,
Hospital Universiti Sains Malaysia were collected and analyzed prospectively. The blood
samples were subjected to standard blood bank procedure for antibody screening and
identification. The infant of women with positive antibody screening was monitored for
evidence ofHDFN.
Fifty one (0.99%) pregnant women were found to have irregular RBC alloantibodies and
when the specificities were further characterized, 30 (0.58%) women were found to
possess clinically significant alloantibody. Most of the clinically significant alloantibodies
belonged to Rhesus (Rh) system (55.8%) where anti-E (33.3%) was the most common
antibody identified, followed by anti-D (10.0%). Fourteen (0.27%) infants were clinically considered to develop HDFN. Anti-D, anti-c and anti-K were identified to cause moderate
to severe HDFN.
In conclusion, prevalence of RBC alloantibody in Malay pregnant women is low (<1 %),
which is similar to other published studies. There were differences in the distribution of
alloantibody specificity, however the antibodies toward Rh antigen are still the commonest
clinically significant alloantibody identified. Considering the low prevalence of clinically
significant alloantibodies and HDFN, the value of current routine antenatal RBC antibody
screening practice in most Western countries becomes questionable and may not be
directly applicable to Malaysian community without modification. The antibody screen
should be restricted to women who are RhD negative, or who have a history of HDFN
especially due to anti-c and anti-K. |
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