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dc.contributor.authorBollason, Gunnar
dc.contributor.authorHjartardottir, Hulda
dc.contributor.authorJonsson, Thorbjorn
dc.contributor.authorGudmundsson, Sveinn
dc.contributor.authorKjartansson, Sveinn
dc.contributor.authorHalldorsdottir, Anna Margret
dc.date.accessioned2017-11-24T13:30:22Z
dc.date.available2017-11-24T13:30:22Z
dc.date.issued2017-11
dc.date.submitted2017
dc.identifier.citationRed blood cell alloimmunization in pregnancy during the years 1996-2015 in Iceland: a nation-wide population study 2017, 57 (11):2578 Transfusionen
dc.identifier.issn00411132
dc.identifier.doi10.1111/trf.14262
dc.identifier.urihttp://hdl.handle.net/2336/620362
dc.descriptionTo access publisher's full text version of this article click on the hyperlink belowen
dc.description.abstractBACKGROUND: Red blood cell (RBC) alloimmunization during pregnancy is still a major problem. Historically, anti-D antibodies are most likely to cause severe hemolysis, but other antibodies are also important. In Iceland, postnatal RhIg prophylaxis was implemented in 1969, universal RBC antibody screening was implemented in 1978, but antenatal RhIg prophylaxis is not yet routine. STUDY DESIGN AND METHODS: This nation-wide population study gathered data on alloimmunized pregnancies in Iceland between 1996 and 2015. Blood bank alloimmunization data were linked to Icelandic Medical Birth Registry data. RBC antibodies were classified as either clinically significant or clinically nonsignificant. RESULTS: In total, 912 positive antibody screens from 87,437 births were identified (1.04% prevalence). The most frequent antibodies were anti-M (19.4%), anti-E (19.0%), and anti-D (12.5%). Anti-D prevalence among D-negative mothers was 1.1%. Icelandic Medical Birth Registry data were available for 881 (96.6%) pregnancies. In the clinically significant group (n = 474), anti-E (27%) and anti-D (20%) were most common, whereas anti-M was most frequent (53%) in the clinically nonsignificant group (n = 407). Mothers in the clinically significant group were older, more often multigravidae, had more abortions and stillbirths, and had shorter gestational length. Newborns in the clinically significant group were less healthy, had lower weight and Apgar scores, and required more treatment. Among specificities in the clinically significant group, anti-D antibodies were most strongly associated with severe hemolysis. CONCLUSION: In this study, the prevalence of alloimmunization was similar to that in previous reports. Of all clinically significant antibodies, anti-D was most strongly associated with severe hemolysis, requiring phototherapy or exchange transfusions. Our data emphasize the importance of implementing an antenatal prophylactic RhIg program in Iceland in the near future.
dc.language.isoenen
dc.publisherWileyen
dc.relation.urlhttp://doi.wiley.com/10.1111/trf.14262en
dc.rightsArchived with thanks to Transfusionen
dc.subjectBlóðflokkaren
dc.subjectMeðgangaen
dc.subjectNýburaren
dc.subjectOAG12en
dc.subjectBAB12en
dc.subjectPED12en
dc.subject.meshRho(D) Immune Globulinen
dc.subject.meshErythroblastosis, Fetalen
dc.subject.meshInfant, Newbornen
dc.titleRed blood cell alloimmunization in pregnancy during the years 1996-2015 in Iceland: a nation-wide population studyen
dc.typeArticleen
dc.contributor.department[ 1 ] Univ Iceland, Fac Med, Reykjavik, Iceland [ 2 ] Landspitali Univ Hosp, Dept Obstet & Gynecol, Reykjavik, Iceland [ 3 ] Landspitali Univ Hosp, Blood Bank, Reykjavik, Iceland [ 4 ] Landspitali Univ Hosp, Dept Pediat, Reykjavik, Icelanden
dc.identifier.journalTransfusionen
dc.rights.accessNational Consortium - Landsaðganguren
dc.contributor.institutionUniversity of Iceland, Faculty of Medicine; Reykjavik Iceland
dc.contributor.institutionDepartment of Obstetrics and Gynecology; Landspitali University Hospital; Reykjavik Iceland
dc.contributor.institutionUniversity of Iceland, Faculty of Medicine; Reykjavik Iceland
dc.contributor.institutionBlood Bank, Landspitali University Hospital; Reykjavik Iceland
dc.contributor.institutionDepartment of Pediatrics; Landspitali University Hospital; Reykjavik Iceland
dc.contributor.institutionUniversity of Iceland, Faculty of Medicine; Reykjavik Iceland
html.description.abstractBACKGROUND: Red blood cell (RBC) alloimmunization during pregnancy is still a major problem. Historically, anti-D antibodies are most likely to cause severe hemolysis, but other antibodies are also important. In Iceland, postnatal RhIg prophylaxis was implemented in 1969, universal RBC antibody screening was implemented in 1978, but antenatal RhIg prophylaxis is not yet routine. STUDY DESIGN AND METHODS: This nation-wide population study gathered data on alloimmunized pregnancies in Iceland between 1996 and 2015. Blood bank alloimmunization data were linked to Icelandic Medical Birth Registry data. RBC antibodies were classified as either clinically significant or clinically nonsignificant. RESULTS: In total, 912 positive antibody screens from 87,437 births were identified (1.04% prevalence). The most frequent antibodies were anti-M (19.4%), anti-E (19.0%), and anti-D (12.5%). Anti-D prevalence among D-negative mothers was 1.1%. Icelandic Medical Birth Registry data were available for 881 (96.6%) pregnancies. In the clinically significant group (n = 474), anti-E (27%) and anti-D (20%) were most common, whereas anti-M was most frequent (53%) in the clinically nonsignificant group (n = 407). Mothers in the clinically significant group were older, more often multigravidae, had more abortions and stillbirths, and had shorter gestational length. Newborns in the clinically significant group were less healthy, had lower weight and Apgar scores, and required more treatment. Among specificities in the clinically significant group, anti-D antibodies were most strongly associated with severe hemolysis. CONCLUSION: In this study, the prevalence of alloimmunization was similar to that in previous reports. Of all clinically significant antibodies, anti-D was most strongly associated with severe hemolysis, requiring phototherapy or exchange transfusions. Our data emphasize the importance of implementing an antenatal prophylactic RhIg program in Iceland in the near future.


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