Incidence of Rh immunization between 1981 and 1992.

ABSTRACT

BACKGROUND. The Institute of Immunohaematology has had an Rh clinic at the Nowrosjee Wadia Maternity Hospital since 1957. Between then and 1977, 5% Rh-negative women produced Rh antibodies. Between 1978 and 1980, the rate of immunization was reduced to 3.3%. In the present study we determined the incidence of Rh immunization between 1981 and 1992. METHODS. ABO and Rh grouping was carried out by standard methods on 139,635 samples collected from antenatal women. Six thousand nine hundred and fourteen (5%) Rh-negative women were screened for Rh antibodies using an enzyme technique. Analysis was carried out by dividing the data into four groups, each of three years duration. RESULTS. The number of women attending the antenatal outpatients increased steadily but the frequency of Rh-negativity remained at approximately 5%. The rate of Rh immunization among Rh-negative women declined from 3.1% during 1981-83 to 1.7% during 1990-92. The rate among pregnant women dropped from 0.16% to 0.09% and this was statistically significant (p < 0.05). The incidence of Rh immunization among Rh-negative women increased from 0.4% in the first pregnancy to 17.5% after four or more pregnancies (p < 0.01). Only 15 out of 167 Rh immunized women had received anti-D immunoglobulin previously. CONCLUSIONS. The incidence of Rh immunization has declined during the last 12 years possibly due to family planning and extensive use of anti-D immunoglobulin. However, complete eradication of Rh haemolytic disease of the newborn will be possible only if a comprehensive Rh prophylaxis programme is instituted.