title: Alloimmunisation during pregnancy in Greece: need for nationwide HDFN prevention programme.
abstract: OBJECTIVE
  To access the incidence and specificity of maternal red blood cells alloimmunisation and its relevant clinical impact in Greece.
  
  
  BACKGROUND
  The rate of alloimmunisation in pregnant women in Greece is unknown.
  
  
  METHODS
  We performed a 4-year study in two tertiary hospitals in Greece. Demographics, transfusion and obstetric history were analysed. Maternal alloimmunisation was detected with indirect anti-globulin test.
  
  
  RESULTS
  We investigated 4368 pregnant women. Of which 3292 (75·37%) were Greek and 1076 (24·63%) were migrants. In 39 alloimmunised women, 41 alloantibodies were detected (0·89%). The incidence of alloimmunisation was 0·66% (22/3292) in Greeks and 1·76% (17/1076) in migrants (P = 0·01). Anti-D was the most frequent alloantibody (0·18%). Anti-D was more frequent in migrants; 5·76% compared to 0·56% in Greek RhD negative women (P = 0·002). Other antibody specificities in declining frequency rank were anti-K, anti-E, anti-Lea, anti-M, anti-c, anti-Ce, anti-Jka, anti-Jkb and anti-C. Primiparae vs para >2 and past history of blood transfusion were significantly associated with alloimmunisation during pregnancy (P = 0·0088, P < 0·0001, respectively).
  
  
  CONCLUSIONS
  Our results depict differences in the delivery of health care between migrants and Greek women, as well as the heterogeneity in practices for the prevention of haemolytic disease of foetus and newborn in Greece and highlight the need for the implementation of nationwide guidelines.
authors.affiliation: General Hospital of Nikea, Blood Transfusion Centre, D. Mantouvalou 3, Nikea, Athens, Greece. leontinif@gmail.com
authors.forename: L
authors.initials: L
authors.lastname: Foudoulaki-Paparizos
authors.forename: S
authors.initials: S
authors.lastname: Valsami
authors.forename: N
authors.initials: N
authors.lastname: Bournas
authors.forename: A
authors.initials: A
authors.lastname: Tsantes
authors.forename: P
authors.initials: P
authors.lastname: Grapsas
authors.forename: G
authors.initials: G
authors.lastname: Mantzios
authors.forename: A
authors.initials: A
authors.lastname: Travlou
authors.forename: M
authors.initials: M
authors.lastname: Politou
mesh_terms: D054242:Emigrants and Immigrants; D005260:Female; D005331:Fetomaternal Transfusion / Q000097:blood* / Q000453:epidemiology* / Q000517:prevention & control; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007518:Isoantibodies / Q000097:blood*; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D012204:Rh-Hr Blood-Group System / Q000097:blood; D062606:Tertiary Care Centers
chemical_list: D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System; C026410:Rho(D) antigen
keywords: anti-D; maternal alloimmunisation; pregnancy