A1 Alkuperäisartikkeli tieteellisessä aikakauslehdessä

Time points and risk factors for RhD immunizations after the implementation of targeted routine antenatal anti-D prophylaxis: A retrospective nationwide cohort study




Julkaisun tekijät: Jernman Riina, Isaksson Camilla, Haimila Katri, Kuosmanen Malla, Mäkikallio-Anttila Kaarin, Toivonen Suvi, Orden Maija-Riitta, Sulin Kati, Tihtonen Kati, Vaarasmäki Marja, Sainio Susanna

Kustantaja: WILEY

Julkaisuvuosi: 2021

Journal: Acta Obstetricia et Gynecologica Scandinavica

Lehden akronyymi: ACTA OBSTET GYN SCAN

Volyymi: 100

Julkaisunumero: 10

Sivujen määrä: 8

ISSN: 0001-6349

eISSN: 1600-0412

DOI: http://dx.doi.org/10.1111/aogs.14216


Tiivistelmä

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% versus 19%, the second sample at 24-26 weeks in 20% versus 50%, and the third screening at 36 weeks in 28% versus 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.


Last updated on 2021-14-10 at 15:40