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Hemolytische ziekte van de pasgeborene en irregulaire- bloedgroepantagonisme in Nederland: Prevalentie en morbiditeit [Haemolytic disease of the newborn and irregular blood group antagonism in the Netherlands: Prevalence and morbidity]

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Author: Dijk, B.A. van · Hirasing, R.A. · Overbeeke, M.A.M.
Institution: TNO Preventie en Gezondheid
Source:Nederlands Tijdschrift voor Geneeskunde, 28, 143, 1465-1469
Identifier: 235084
Keywords: Health · Bilirubin · Erythrocyte antibody · Rhesus d antibody · Antibody detection · Bilirubin blood level · Blood group incompatibility · Blood transfusion · High risk pregnancy · Morbidity · Newborn · Newborn hemolytic disease · Prevalence · Blood Group Incompatibility · Blood Transfusion · Erythroblastosis, Fetal · Female · Humans · Hyperbilirubinemia · Incidence · Infant, Newborn · Isoantibodies · Kell Blood-Group System · Male · Mass Screening · Netherlands · Pregnancy · Pregnancy Complications, Hematologic · Prevalence · Prospective Studies · Registries · Rh-Hr Blood-Group System


Objective. To inventory prevalence and morbidity of haemolytic disease of newborn caused by irregular anti-erythrocyte antibodies other than antirhesus-D. Design. Prospective registration study. Method. All paediatricians (n = 380) in general hospitals and contact persons (n = 79) in university hospitals were asked for monthly reports of clinical cases of haemolytic disease of newborn during 2 years (1996-1997). Results. Response was 97%. A total of 130 reports were received in two study years, 49 of which could not be confirmed as non-RhD-non-AB0 antagonism. In the group of which the transfusion history was known (n = 60), 29 pregnant women (48%) had received transfused blood at some time. Of the antibodies found, anti-c, anti-E and anti-K were the most frequent. The direct antiglobulin test was positive in 61 of the 81 cases, negative in to cases, while in 10 cases it was unknown or false-negative due to earlier intrauterine transfusions (in three neonates). The highest bilirubin levels recorded were 572, 559 and 520 μ/mol/l (all three with maternal anti-c antagonism). Therapeutic data were known concerning 80 of the 81 newborn: 21 (16%) received no treatment, 24 (29%) only phototherapy and the others - in addition to phototherapy if any also blood transfusion, exchange transfusion or intrauterine transfusion, or a combination of these. Conclusion. It was calculated that the actual prevalence of irregular anti-erythrocyte antibodies in Dutch pregnant women probably amounts to approximately 0.25%. This finding may possibly be confirmed since starting 1 July 1998 all pregnant women in the country are screened for the presence of these antibodies. It is recommended that girls and women in the reproductive age group should receive primary prevention of development of irregular anti-erythrocyte antibodies by application of a selective blood transfusion policy, taking into account the occurrence of the antigens c, E and K. Chemicals/CAS: Isoantibodies; Kell Blood-Group System; Rh-Hr Blood-Group System