Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population

Mohd Nazri Hassan; Noor Haslina Mohd Noor; Shah Reza Johan Noor; Salamah Ahmad Sukri; Rapiaah Mustafa; Hans Van Rostenberghe Luc Aster

doi:10.4103/0973-6247.137449

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ORIGINAL ARTICLE

Year : 2014 | Volume : 8 | Issue : 2 | Page : 113-117

Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population

Mohd Nazri Hassan¹, Noor Haslina Mohd Noor¹, Shah Reza Johan Noor², Salamah Ahmad Sukri¹, Rapiaah Mustafa¹, Hans Van Rostenberghe Luc Aster³
¹ Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia
² Department of Obstetrics and Gynaecology, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia
³ Department of Paediatric, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia, Malaysia

Correspondence Address:
Mohd Nazri Hassan
Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan
Malaysia

Source of Support: None, Conflict of Interest: None

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DOI: 10.4103/0973-6247.137449

Background: Maternal red blood cell (RBC) alloimmunization may lead to production of harmful antibodies that result in hemolytic disease of fetus and newborn (HDFN). There is insufficient data on the prevalence of HDFN due to RBC alloantibodies in the Malay neonatal population. Aim: The aim of this study was to determine the incidence of HDFN in the Malay neonatal population due to clinically significant RBC alloantibodies. Subjects and Methods: A cross sectional study was conducted in Transfusion Medicine Unit, Hospital Universitiy Sains Malaysia over one year period from January to December 2009. A total of 5163 Malay pregnant women who attended labor room for delivery were collected and analyzed prospectively. The blood samples were subjected to the standard immunohematological procedure for RBC antibody screening and identification using reagents of Diamed-ID Gel microtyping system. All the newborns with RBC alloantibody were investigated for the evidence of HDFN. Results: Thirty (0.58%) women were found to have clinically significant RBC alloantibodies. Most of the alloantibodies belonged to Rhesus (Rh) system (56.7%) where anti-E (33.3%) was the most common followed by anti-D (10.0%). Rh antibodies were the main cause of HDFN in fourteen (0.27%) neonates. Anti-D and anti-c were identified to cause moderate to very severe HDFN . Conclusions: With the low prevalence of clinically significant RBC alloantibodies and HDFN, routine antenatal antibody screening practice may not be advised as a routine practice at present, preferably reserved for those women of RhD negative or with history of HDFN, significantly of those attributed to anti-c.

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