Anti-D Antibody Prevalence and Its Role in Hemolytic Disease Among Fetuses and Neonates in Erbil City

Abbas Bahram Younus, Bestoon Shekhany, Mohammed Omar Abdullah, Faruk Suzergoz

Abstract


Background: Hematologists and obstetricians have focused their attention on the Rh antigen alloimmunization, especially the Rh-D antigen, which leads to severe health defects such as haemolytic disease of the fetus and newborn (HDFN). This study aimed to develop a profile for mothers with negative Rh-D who get pregnant with babies with positive Rh-D and to determine the rate of anti-D antibodies.

Methods: In this study, 1028 blood samples were collected from 514 parents, who are mothers with Rh-negative and fathers with Rh-positive, in Erbil city of Iraq, from April 2022 to April 2023. All participating mothers were Rh-negative women married to Rh-positive men, and inclusion was not limited to those with a prior Rh-positive child. However, most participants had experienced at least one pregnancy, and their obstetric histories were recorded through verbal interviews. This ensures that the reported 1.7% prevalence of anti-D antibodies represents all Rh-negative mothers with Rh-positive partners, rather than a pre-selected subgroup. Next, ABO and RhD typing tests were done for all samples (fathers and mothers), and then the Du test and antibody screening were applied to all mother samples.

Results: Mothers’ blood samples were divided into age groups: 20-25: 35 (7%), 26-30: 165 (32%), 31-35: 191 (37%), 36-40: 112 (22%), and over 40: 11 (2%). Among Rh-negative mothers, blood group O was most common (40.3%), and AB least (2.9%). Of the nine anti-D–positive mothers, the highest distribution was observed in the 36–40 age group (44%), followed by 26–30 and 31–35 (22% each), and over 40 (11%), with no cases in the 20–25 age group.

Conclusion: The abortion rate showed a positive correlation with increasing maternal age and pregnancy duration. Anti-D antibodies and other alloantibodies have become the major cause of HDFN. Therefore, primary screening for antibodies, monitoring, and blood transfusion are crucial in order to prevent the severity of the antibody effect on the infant.

Keywords: HDFN, Haemolytic disease, Rh-D, Anti-D, Abortion


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References


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DOI: http://dx.doi.org/10.62940/als.v12i3.2389

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