Intrauterine transfusion for rhesus alloimmunization elevates fetal beta2-microglobulin levels.
BACKGROUND
Intrauterine transfusions for rhesus alloimmunization leads to alterations in circulating T-cell populations. Given that elevations in circulating beta2-microglobulin are a marker of T-cell-mediated organ transplant rejection, we evaluated the effect of intrauterine transfusion on fetal beta2-microglobulin levels.


METHODS
Umbilical venous samples were obtained immediately prior to initial transfusion in ten anemic fetuses and in 12 fetuses with prior transfusions. Samples were also obtained from 18 gestational age-matched non-anemic fetuses and eight healthy neonates.


RESULTS
The median concentration of beta2-microglobulin was significantly higher in fetuses with prior transfusions compared with non-anemic controls. In non-anemic controls, and in transfused fetuses, beta2-microglobulin levels decreased throughout gestation (r = -0.69, p = 0.01; and r = -0.80, p = 0.01, respectively). Among anemic and transfused fetuses, beta2-microglobulin levels displayed a negative correlation with fetal hematocrit (r = -0.62, p < 0.05; and r = -0.58, p = 0.04, respectively).


CONCLUSIONS
We conclude that intrauterine transfusion for fetal anemia is associated with increased beta2-microglobulin levels, suggesting immunomodulatory effects of intrauterine transfusion on host immune responses to donor leukocyte antigens.
Radunovic
N
N
Institute for Obstetrics and Gynecology, University of Belgrade, Belgrade, Yugoslavia.
Kuczynski
E
E
Funai
E F
EF
Nastic
D
D
Di Renzo
G C
GC
Lockwood
C J
CJ
D000740:Anemia / Q000097:blood; D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D005315:Fetal Diseases / Q000097:blood; D005865:Gestational Age; D006400:Hematocrit; D006801:Humans; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000628:therapy*; D001613:beta 2-Microglobulin / Q000097:blood*
D001613:beta 2-Microglobulin