[Hemolytic disease of the newborn and irregular blood group antibodies in the Netherlands: prevalence and morbidity].
OBJECTIVE
To inventory prevalence and morbidity of haemolytic disease of newborn caused by irregular anti-erythrocyte antibodies other than antirhesus-D.


METHODS
Prospective registration study.


METHODS
All paediatricians (n = 380) in general hospitals and contact persons (n = 79) in university hospitals were asked for monthly reports of clinical cases of haemolytic disease of newborn during 2 years (1996-1997).


RESULTS
Response was 97%. A total of 130 reports were received in two study years, 49 of which could not be confirmed as non-RhD-non-AB0 antagonism. In the group of which the transfusion history was known (n = 60), 29 pregnant women (48%) had received transfused blood at some time. Of the antibodies found, anti-c, anti-E and anti-K were the most frequent. The direct antiglobulin test was positive in 61 of the 81 cases, negative in 10 cases, while in 10 cases it was unknown or false-negative due to earlier intrauterine transfusions (in three neonates). The highest bilirubin levels recorded were 572, 559 and 520 mumol/l (all three with maternal anti-c antagonism). Therapeutic data were known concerning 80 of the 81 newborn: 21 (16%) received no treatment, 24 (29%) only phototherapy and the others--in addition to phototherapy if any--also blood transfusion, exchange transfusion or intrauterine transfusion, or a combination of these.


CONCLUSIONS
It was calculated that the actual prevalence of irregular anti-erythrocyte antibodies in Dutch pregnant women probably amounts to approximately 0.25%. This finding may possibly be confirmed since starting 1 July 1998 all pregnant women in the country are screened for the presence of these antibodies. It is recommended that girls and women in the reproductive age group should receive primary prevention of development of irregular anti-erythrocyte antibodies by application of a selective blood transfusion policy, taking into account the occurrence of the antigens c, E and K.
van Dijk
B A
BA
TNO Preventie en Gezondheid, divisie Jeugd, Leiden, Amsterdam.
Hirasing
R A
RA
Overbeeke
M A
MA
D001787:Blood Group Incompatibility / Q000453:epidemiology* / Q000276:immunology* / Q000517:prevention & control; D004899:Erythroblastosis, Fetal / Q000453:epidemiology* / Q000276:immunology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D006932:Hyperbilirubinemia / Q000276:immunology / Q000517:prevention & control; D015994:Incidence; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood*; D007626:Kell Blood-Group System / Q000276:immunology*; D008297:Male; D008403:Mass Screening; D009426:Netherlands / Q000453:epidemiology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000453:epidemiology* / Q000276:immunology* / Q000517:prevention & control; D015995:Prevalence; D011446:Prospective Studies; D012042:Registries; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D065227:Transfusion Reaction
D007518:Isoantibodies; D007626:Kell Blood-Group System; D012204:Rh-Hr Blood-Group System
Hemolytische ziekte van de pasgeborene en irregulaire-bloedgroepantagonisme in Nederland: prevalentie en morbiditeit.