title: Postnatal outcome in neonates with severe Rhesus c compared to rhesus D hemolytic disease.
abstract: BACKGROUND
  Neonates with Rhesus c (Rh c) hemolytic disease of the fetus and newborn (HDFN) are often managed in the same way as neonates with Rhesus D (Rh D) HDFN, although evidence to support this policy is limited. The objective of this study was to evaluate neonatal outcome in severe Rh c HDFN compared to Rh D HDFN.
  
  
  METHODS
  A retrospective study of (near-)term neonates with severe Rh c (n = 22) and Rh D HDFN (n = 103; without additional antibodies) admitted to the Leiden University Medical Center between January 2000 and October 2011 was conducted. The need for intrauterine transfusions (IUTs), phototherapy, exchange transfusions (ETs), and top-up transfusions up to 3 months of age were recorded and compared between both groups.
  
  
  RESULTS
  Although there was a trend for a slightly more severe antenatal course for Rh D HDFN reflected by an earlier need for and higher number of IUTs (median [interquartile range], 2 [1.5-4] vs. 2 [1-2] in Rh c HDFN; p = 0.070), no significant differences were found for the postnatal course between Rh c and Rh D group in days of phototherapy (mean, Days 4.8 and 4.6, respectively; p = 0.569), need for ET (50% vs. 44%, respectively; p = 0.589), and top-up transfusions (62% vs. 78%, respectively; p = 0.128).
  
  
  CONCLUSIONS
  Postnatal outcome in neonates with severe Rh c HDFN is similar compared to neonates with severe Rh D hemolytic disease in terms of days of phototherapy, need for ET, and need for top-up transfusions. These results justify a similar postnatal management of neonates with Rh D and Rh c HDFN.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Sanquin Blood Bank, Southwest Region, The Netherlands.
authors.forename: Mirjam E A
authors.initials: ME
authors.lastname: Rath
authors.forename: Vivianne E H J
authors.initials: VE
authors.lastname: Smits-Wintjens
authors.forename: Irene T M
authors.initials: IT
authors.lastname: Lindenburg
authors.forename: Claudia C
authors.initials: CC
authors.lastname: Folman
authors.forename: Anneke
authors.initials: A
authors.lastname: Brand
authors.forename: Inge L
authors.initials: IL
authors.lastname: van Kamp
authors.forename: Dick
authors.initials: D
authors.lastname: Oepkes
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
authors.forename: Enrico
authors.initials: E
authors.lastname: Lopriore
mesh_terms: D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000209:etiology* / Q000628:therapy; D005078:Exchange Transfusion, Whole Blood; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood; D010789:Phototherapy; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000150:complications*; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin
chemical_list: D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin; C026410:Rho(D) antigen