FEMALE ALLOIMMUNIZATION WITH ANTIBODIES KNOWN TO CAUSE HEMOLYTIC-DISEASE

Objective: To determine the current frequency of red blood cell antige n alloimmunizations that are capable of causing hemolytic disease and would be suitable for prenatal DNA studies. Methods: We reviewed blood -bank records at a single large tertiary center to identify patients w ith a positive antibody screen between January 1993 and June 1995. Dat a were analyzed based on age, gender, and specific blood-group alloimm unizations. The incidence of antibodies as published in the literature was reviewed and compared with our data. Results: We identified 452 w omen who had a positive antibody screen. The frequencies of specific a lloimmunization relevant to the development of fetal hemolytic disease were: anti-D, 18.4%; anti-E, 14%; anti-c, 5.8%; anti-C 4.7%; Kell gro up, 22%; anti-MNS, 4.7%; anti-Fy(a) (Duffy), 5.4%; and anti-Jk(a), 1.5 %. Compared with other populations, in our group the frequency of anti bodies to RhD decreased and Kell alloimmunization increased between 19 67 and 1996. Conclusions: Despite the use of rhesus immune globulin, a nti-D is still a common antibody identified in women presenting to a t ertiary care center. The frequency of the Kell-group alloimmunization is higher among the central New York female population than in other p opulations. Rhesus and Kell antigen status can be determined by DNA st udies. Research in prenatal determination of fetal antigen status shou ld continue, as alloimmunization to these antigens is common. Copyrigh t (C) 1997 by The American College of Obstetricians and Gynecologists.