University of Oulu

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

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

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Author: Jernman, Riina1; Isaksson, Camilla1; Haimila, Katri2;
Organizations: 1Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
2Finnish Red Cross Blood Service, Helsinki, Finland
3Department of Obstetrics and Gynecology, Turku University Hospital, Turku, Finland
4Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland
5Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
6Department of Obstetrics and Gynecology, Oulu University Hospital, Oulu, Finland
Format: article
Version: accepted version
Access: embargoed
Persistent link: http://urn.fi/urn:nbn:fi-fe2021102552185
Language: English
Published: John Wiley & Sons, 2021
Publish Date: 2022-06-22
Description:

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.

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Series: Acta obstetricia et gynecologica Scandinavica
ISSN: 0001-6349
ISSN-E: 1600-0412
ISSN-L: 0001-6349
Volume: 100
Issue: 10
Pages: 1868 - 1875
DOI: 10.1111/aogs.14216
OADOI: https://oadoi.org/10.1111/aogs.14216
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Subjects:
Funding: Grants were received from the Päivikki and Sakari Sohlberg Foundation and Helsinki University Hospital Obstetrics Department Research Funding.
Copyright information: © 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.