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Acta Obstet Gynecol Scand ; 100(10): 1868-1875, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34157128

ABSTRACT

INTRODUCTION: Targeted routine antenatal anti-D prophylaxis was introduced to the national prophylaxis program in Finland in late 2013. The aim of this study was to assess the incidence, time-points, and risk factors for Rhesus D immunization after the implementation of routine antenatal anti-D prophylaxis, in all women in Finland with antenatal anti-D antibodies detected in 2014-2017. MATERIAL AND METHODS: In a nationwide population-based retrospective cohort study, the incidence, time-points, and risk factors of anti-D immunizations were analyzed. Information on antenatal screening was obtained from the Finnish Red Cross Blood Service database, and obstetric data from hospital records and the Finnish Medical Birth Register. RESULTS: The study included a total of 228 women (197 with complete data for all pregnancies). After the implementation of routine antenatal anti-D prophylaxis, the prevalence of pregnancies with anti-D antibodies decreased from 1.52% in 2014 to 0.88% in 2017, and the corresponding incidence of new immunizations decreased from 0.33% to 0.10%. Time-points for detection of new anti-D antibodies before and after 2014 were the first screening sample at 8-12 weeks of gestation in 52% vs 19%, the second sample at 24-26 weeks in 20% vs 50%, and the third screening at 36 weeks in 28% vs 32%. CONCLUSIONS: The incidence of new anti-D immunizations decreased as expected after the implementation of routine antenatal anti-D prophylaxis. True failures are rare and they mainly occur when the prophylaxis is not given appropriately, suggesting a need for constant education of healthcare professionals on the subject.


Subject(s)
Pregnancy Complications, Hematologic/drug therapy , Prenatal Care , Rh Isoimmunization/epidemiology , Rh-Hr Blood-Group System , Rho(D) Immune Globulin/administration & dosage , Adult , Cohort Studies , Female , Finland/epidemiology , Humans , Incidence , Pregnancy , Retrospective Studies , Rh Isoimmunization/etiology , Rh Isoimmunization/prevention & control , Risk Factors , Time Factors
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