Reduction of anti-K-mediated hemolytic disease of newborns after the introduction of a matched transfusion policy: A nation-wide policy change evaluation study in the Netherlands.
Transfusion
; 61(3): 713-721, 2021 03.
Article
en En
| MEDLINE
| ID: mdl-33528025
ABSTRACT
BACKGROUND:
During pregnancy, maternal red blood cell (RBC) antibodies can lead to life-threatening fetal hemolysis and anemia. Women can become immunized by a pregnancy or an unmatched transfusion. Our aim was to quantify the effect of a nationwide K-matched transfusion policy for women of childbearing age potential to prevent K-immunization in pregnancy. STUDY DESIGN ANDMETHODS:
In this nation-wide policy change evaluation study we determined the occurrence of RBC antibodies before and after introduction of a K-matched transfusion policy and evaluated the cause K alloimmunization 10 years after introduction of this measure. K-matched transfusion for females under 45 years of age is advised in the Dutch transfusion guideline since 2004. We used laboratory data from pregnancies with RBC antibodies identified in the period 1999-2018 obtained as part of a population-based screening program in the Netherlands.RESULTS:
Tests of 36 286 pregnancies produced a positive antibody screening result which concerned anti-K in 1550 pregnancies. The occurrence of anti-K decreased from 67.9 to 20.2 per 100 000 pregnancies. The relative risk reduction was 0.70 which largely exceeded the relative risk reduction of 0.27 for antibodies against RBC antigens for which no preventive matching is required. The number of pregnancies at risk for anti-K-mediated disease decreased from 9.7 to 4.2 per 100 000 pregnancies.CONCLUSIONS:
A K-matched transfusion policy is associated with a major decrease in a number of pregnant women with anti-K and pregnancies at risk for anti-K-mediated disease. A relatively simple measure is now shown to impact prevention of hemolytic disease in the fetus and newborn.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Incompatibilidad de Grupos Sanguíneos
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Transfusión Sanguínea
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Eritroblastosis Fetal
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Eritrocitos
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Hemólisis
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Isoanticuerpos
/
Sistema del Grupo Sanguíneo de Kell
Tipo de estudio:
Etiology_studies
/
Evaluation_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Female
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Humans
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Newborn
/
Pregnancy
País/Región como asunto:
Europa
Idioma:
En
Revista:
Transfusion
Año:
2021
Tipo del documento:
Article
País de afiliación:
Países Bajos