Maternal alloimmunization as a risk factor of haemolytic disease of the foetus and newborn in Owerri metropolis, Nigeria
Keywords:
maternal, Alloimmunization, Rhesus, antibodies, foetus, newborn haemolytic anti-D immunoglobulin prophylaxis., maternal, Alloimmunization, Rhesus, antibodies, foetus, newborn haemolytic anti-D immunoglobulin prophylaxisAbstract
Blood group incompatibility between mother and her foetus which usually arises as a result of heterospecific pregnancy causes haemolytic disease of the foetus and newborn (HDN). Five hundred (500) pregnant women attending antenatal clinic at Federal Medical Centre (FMC), Owerri were recruited for this research work. They were aged between 17 and 40 years. All subjects gave informed consent to participate in the study. They were screened for ABO blood groups RhD status and immune alloantibodies. Anti-A and anti-B from group O subjects compared with anti-A from group B women and anti-B from group A women among the trimester. The rate of RhD negativity (5.4%) was significantly lower than the RhD positively (94.6%) (P<0.005). Haemolysin tests were positive in 110 (22.0%) cases and negative in 390 (78.0%) cases. Group O women produced more alpha and / or beta haemolysins than either A or B women (P<0.005). Anti-A titres were higher in the trimesters than anti-B. Indirect antiglobulin test (IAT) was positive in 12(80.0%) cases among ABO group and positive in 3(20.0%) cases among RhD group. There was a higher prevalence of ABO HDN than RhD HDN in the ratio of 3:1 respectively. This study illustrates the presence of immune alloantibodies in the sera of allominiunized pregnant women and the rise in the antibody titres has helped to identify pregnancies at risk of foetal and neonatal HDN. Anti-D immunoprophylaxis has made HDN caused by sensitization to the D-antigen a preventable disease and prenatal deaths from allominization by immunoprophylaxis has been primarily responsible for the dramatic reduction in the diseases, although changes in family size and the quality of prenatal care have also contributed.
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