THE PREVALENCE OF RED-CELL ANTIBODIES IN PREGNANCY CORRELATED TO THE OUTCOME OF THE NEWBORN - A 12 YEAR STUDY IN CENTRAL SWEDEN

Background. All maternal red cell antibodies found during pregnancy in a 12 year period have been compiled. The efficacy of the current ante natal screening and management programme has been ascertained by revie wing the outcome of all newborns to these immunized mothers. Method. P atient selection was carried out by computerised searching for all kno wn records of registered antibodies during the study period. Each moth er's obstetric record and her baby's hospital file was studied and rel evant clinical treatment and laboratory data on both mother and child was recorded and analysed. Results. Eight hundred and twenty-one alloa ntibodies were detected in 629 immunized pregnant women with 753 fetus es. An overall antibody incidence of 0.57% was observed which included 373 clinically significant antibodies found in 261 mothers (0.24%). M ultiple antibodies were present in 8.2% of all samples. Anti-D, by its elf or in combination with other Rh-antibodies, caused more severe for ms of hemolytic disease of the newborn (HDN) with 46% of all Ph-positi ve babies having phototherapy and 29% having exchange transfusion. Thr ee of 18 Fy(a)-positive infants required phototherapy and one required exchange transfusion and in the 16 Kell-positive babies, three requir ed phototherapy and one required exchange transfusions. Conclusions. F ew antibodies to blood group antigens other than those in the Rhesus s ystem were found to cause severe HDN. Antibodies that are generally co nsidered non-significant did not cause HDN in this study. All antibodi es that induced HDN were detected in time so that adequate measures co uld be taken to reduce the effects in the newborn. The antenatal scree ning and management programme currently in use is considered to be rel iable.