Efficacy and long term effects of antenatal prophylaxis with anti-D immunoglobulin.
OBJECTIVE
To measure the safety and efficacy of antenatal treatment with anti-D immunoglobulin.


METHODS
Open study with historical controls.


METHODS
Multicentre study in 17 hospitals in West Yorkshire.


METHODS
1238 Rh negative women who delivered Rh positive infants after 34 weeks in their first pregnancy in 1980-1 (group 1) and 2000 similar primigravidas from 1978-9 (group 2). Obstetric data were collected for 616 women in group 1 who had a subsequent pregnancy, 536 similar women in group 2, and 410 Rh positive but otherwise similar primigravidas who delivered in the same hospitals in 1978-81 (group C).


METHODS
Anti-D immunoglobulin 100 micrograms intramuscularly was given at 28 and 34 weeks to the mothers in their first pregnancy who delivered in 1980-1.


METHODS
Detection of anti-D antibody in the first or any subsequent pregnancy in groups 1 and 2. For all three groups having subsequent pregnancies gestation at delivery, birth weight, fetal survival at one month, pre-eclampsia defined as blood pressure greater than 140/90 on two occasions more than 12 hours apart, and proteinuria greater than 0.25 milligram.


RESULTS
Antenatal immunisation to Rh(D) occurred in six mothers in group 1 and 32 group 2. Most immunisations occurred in the first or second pregnancy. The rates of abortion, gestation at delivery, birth weight, and fetal survival were not significantly different among the three groups. The incidence of pre-eclampsia was lower in mothers given antenatal anti-D immunoglobulin, but the difference was not significant.


CONCLUSIONS
Antenatal prophylaxis with anti-D immunoglobulin is effective, and the effect of giving it in the first pregnancy persists into at least the second pregnancy. It seems to be safe for the fetus in the index and subsequent pregnancies.
Thornton
J G
JG
Department of Obstetrics and Gynaecology, General Infirmary, Leeds.
Page
C
C
Foote
G
G
Arthur
G R
GR
Tovey
L A
LA
Scott
J S
JS
D001724:Birth Weight; D004739:England; D005260:Female; D005865:Gestational Age; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage; D007518:Isoantibodies / Q000276:immunology*; D015337:Multicenter Studies as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000276:immunology / Q000517:prevention & control*; D011256:Pregnancy Outcome; D011295:Prenatal Care; D012203:Rh Isoimmunization / Q000276:immunology / Q000517:prevention & control*; D018029:Rho(D) Immune Globulin; D013997:Time Factors
D007136:Immunoglobulins; D007518:Isoantibodies; D018029:Rho(D) Immune Globulin