The First People’s Hospital of Neijiang, China
Summary: The RhD-negative phenotype is widely distributed in different ethnic groups. The rate of RhD-negative people in China is less than 0.5%. Herein, the aim of this study was to determine the necessity to carry out routine antenatal and postpartum anti-D prophylaxis(RAADP) in Chinese women.
Study design and methods: A retrospective study that concentrated on the effectiveness of anti-D prophylaxis was performed in a multicenter in southwest China between January 1st, 2010 to December 31st, 2017. The RhDnegative multi gravid women were selected as the research subject. The women whether had injection of anti-D immunoglobulin (anti-D Ig) in the previous pregnancy was the basis for the grouping, namely the observation group and the control group. We compared the differences between the two groups in the outcome of the subsequent pregnancy.
Results: D antibodies were detected in 17 of 104 D-pregnancies, in 3 cases (5.88%, 95% CI 2.02%, 15.92%) of the observation group and 14 cases (26.42%, 95% CI 16.44%, 39.58%) of the control group. The odds ratio (OR) value was 5.74 (95% CI 1.54,21.43). In 17 cases, there are 13 cases of newborn babies in neonatal intensive care unit (NICU), and the occupancy rate of 76.47%(95% CI 52.74%, 90.44%); 5 cases of newborns for premature babies, and the preterm rate was 29.41%(95% CI 13.28%, 53.13%); and 2 cases of neonatal need exchange transfusion rate of 11.76% (95% 3.29%, 34.34%). Therefore, the production of anti-D antibodies increased the possibilities for the newborns to preterm and be admitted to the NICU.
Conclusions: Nowadays, the anti-D prophylaxis has not been applicable for Chinese people. The full opening of “a couple can have two children”, the improvement of economic level coupled with the popularity of online sales and procurement service made in possible for the application of Rh immunoglobulin (Rh IG). It is recommended that routine red blood cell (RBC) antibody screening and prophylactic Rh IG administration should as part of standard of ante-and postnatal care for women at risk for D antibody formation.
Xie Xiaohui, a 34-year-old, doctor, has been working in the first people’s hospital of Neijiang since 2010. Member of European society of human reproduction and embryology, youth member of Sichuan provincial family planning commission, and member of Sichuan provincial rehabilitation medical association’s obstetrics and gynecology branch, skilled in the diagnosis and treatment of common and frequently occurring gynecology and obstetrics, skilled in the diagnosis and treatment of reproductive endocrine and infertility diseases.