| Title: |
Time points and risk factors for RhD immunizations after the implementation of targeted routine antenatal anti-D prophylaxis:a retrospective nationwide cohort study |
| Authors: |
Jernman, R. (Riina); Isaksson, C. (Camilla); Haimila, K. (Katri); Kuosmanen, M. (Malla); Mäkikallio-Anttila, K. (Kaarin); Toivonen, S. (Suvi); Ordén, M.-R. (Maija-Riitta); Sulin, K. (Kati); Tihtonen, K. (Kati); Vääräsmäki, M. (Marja); Sainio, S. (Susanna) |
| Publisher Information: |
John Wiley & Sons 2021 |
| Document Type: |
Electronic Resource |
| 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. |
| Index Terms: |
anti-D; fetomaternal hemorrhage; immunization; prevention; risk factors; routine antenatal anti-D prophylaxis; info:eu-repo/semantics/article; info:eu-repo/semantics/acceptedVersion |
| URL: |
http://urn.fi/urn:nbn:fi-fe2021102552185 |
| Availability: |
Open access content. Open access content; info:eu-repo/semantics/openAccess; © 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. |
| Note: |
application/pdf; English |
| Other Numbers: |
OUX oai:oulu.fi:nbnfi-fe2021102552185; urn:nbn:fi-fe2021102552185; 1334529005 |
| Contributing Source: |
UNIV OF OULU; From OAIster®, provided by the OCLC Cooperative. |
| Accession Number: |
edsoai.on1334529005 |
| Database: |
OAIster |