Time points and risk factors for RhD immunizations after the implementation of targeted routine antenatal anti-D prophylaxis : a retrospective nationwide cohort study
Jernman, Riina; Isaksson, Camilla; Haimila, Katri; Kuosmanen, Malla; Mäkikallio-Anttila, Kaarin; Toivonen, Suvi; Ordén, Maija-Riitta; Sulin, Kati; Tihtonen, Kati; Vääräsmäki, Marja; Sainio, Susanna (2021-06-22)
Jernman, R, Isaksson, C, Haimila, K, et al. Time points and risk factors for RhD immunizations after the implementation of targeted routine antenatal anti-D prophylaxis: A retrospective nationwide cohort study. Acta Obstet Gynecol Scand. 2021; 100: 1868– 1875. https://doi.org/10.1111/aogs.14216
© 2021 Nordic Federation of Societies of Obstetrics and Gynecology. This is the peer reviewed version of the following article: Jernman, R, Isaksson, C, Haimila, K, et al. Time points and risk factors for RhD immunizations after the implementation of targeted routine antenatal anti-D prophylaxis: A retrospective nationwide cohort study. Acta Obstet Gynecol Scand. 2021; 100: 1868– 1875, which has been published in final form at https://doi.org/10.1111/aogs.14216. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
https://rightsstatements.org/vocab/InC/1.0/
https://urn.fi/URN:NBN:fi-fe2021102552185
Tiivistelmä
Abstract
Background: 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.
Kokoelmat
- Avoin saatavuus [32130]