Maternal anti-D prophylaxis during pregnancy does not cause neonatal haemolysis
A Maayan-Metzgera, T Schwartza, J Sulkesb, P Merlobc
a Department of
Neonatology, Rabin Medical Center, Beilinson Campus, Petah Tiqva,
Israel, b Epidemiology Unit, Rabin Medical Center, c Sackler Faculty of Medicine,
Tel Aviv University, Tel Aviv, Israel
Correspondence to: Dr Maayan-Metzger, Department of Neonatology, Rabin Medical Center, Beilinson Campus, Petah Tiqva 49100, Israel Maayan{at}flashmail.com
Accepted 25 October
2000
OBJECTIVE
To evaluate
signs of haemolysis in babies of Rh-D negative mothers who underwent
prophylaxis with anti-D immunoglobulin during pregnancy.
DESIGNThe following
were evaluated in all babies of Rh-D negative mothers born within a
three month period in our department: haemoglobin level, packed cell
volume, mean corpuscular volume, reticulocytes, bilirubin level, and
direct Coombs' test (direct anti-globulin test). The babies were
divided into two groups according to number of doses of anti-D
immunoglobulin received by the mother (one or two), and then further
divided by their Rh status (negative or positive). Findings were also
compared with a control group of babies of O-Rh positive mothers.
RESULTSThe study
group consisted of 101 babies and the control group of 37 babies. No
statistically significant differences were found for any of the
haematological variables between the babies of mothers who received one
or two doses of anti-D immunoglobulin, or between the Rh negative
babies (n = 35), and the controls. Although 20% of the Rh positive
babies born to mothers receiving two doses of anti-D immunoglobulin had
a positive result in the direct Coombs' test compared with only 2.4%
of the babies of mothers treated with only one dose, no signs of
haemolysis were documented in the babies with a positive Coombs test.
CONCLUSIONThe
prevention of Rh isoimmunisation with anti-D immunoglobulin (one or
two doses) during pregnancy does not jeopardise the newborn. Blood
group typing and direct Coombs' test should be performed in every
newborn of an Rh negative mother to establish whether there is a
necessity to administer anti-D. In the presence of a positive direct
Coombs' test, the type of antibodies should be identified.
Keywords: Rh incompatibility; anti-D prophylaxis; haemolysis; newborn
© 2001 by Archives of Disease in Childhood
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