title: Predictive factors of perinatal mortality in transfused fetuses due to maternal alloimmunization: what really matters?
abstract: BACKGROUND
  Alloimmunization is the main cause of fetal anemia. There are not many consistent analyses associating antenatal parameters to perinatal mortality in transfused fetuses due to maternal alloimmunization. The study aimed to determine the prognostic variables related to perinatal death.
  
  
  METHODS
  A cohort study analyzed 128 fetuses treated with intrauterine transfusion (IUT), until the early neonatal period. Perinatal mortality was associated with prognostic conditions related to prematurity, severity of fetal anemia and IUT procedure by univariated logistic regression. Multiple logistic regression was used to compute the odds ratio (OR) for adjusting the hemoglobin deficit at the last IUT, gestational age at birth, complications of IUT, antenatal corticosteroid and hydrops.
  
  
  RESULTS
  Perinatal mortality rate found in this study was 18.1%. The hemoglobin deficit at the last IUT (OR: 1.26, 95% CI: 1.04-1.53), gestational age at birth (OR: 0.53, 95% CI: 0.38-0.74) and the presence of transfusional complications (OR: 5.43, 95% CI: 142-20.76) were significant in predicting fetal death.
  
  
  CONCLUSIONS
  Perinatal mortality prediction in transfused fetuses is not associated only to severity of anemia, but also to the risks of IUT and prematurity.
authors: Department of Obstetrics and Gynecology, Fetal Medicine Center, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. osanangc@yahoo.com
authors: Gabriel Costa
authors: GC
authors: Osanan
authors: Zilma Nogueira
authors: ZN
authors: Silveira Reis
authors: Isabela Gomes
authors: IG
authors: Apocalypse
authors: Ana Paula Brum
authors: AP
authors: Lopes
authors: Alamanda Kfoury
authors: AK
authors: Pereira
authors: Orquidea Maria
authors: OM
authors: da Silva Ribeiro
authors: Antônio Carlos
authors: AC
authors: Vieira Cabral
mesh_terms: D000328:Adult; D001787:Blood Group Incompatibility / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects / Q000401:mortality* / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D005313:Fetal Death / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005333:Fetus / Q000276:immunology; D005865:Gestational Age; D006801:Humans; D054238:Perinatal Mortality; D011247:Pregnancy; D011379:Prognosis; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D012307:Risk Factors; D055815:Young Adult