title: Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population.
abstract: BACKGROUND
  Maternal red blood cell (RBC) alloimmunization may lead to production of harmful antibodies that result in hemolytic disease of fetus and newborn (HDFN). There is insufficient data on the prevalence of HDFN due to RBC alloantibodies in the Malay neonatal population.
  
  
  OBJECTIVE
  The aim of this study was to determine the incidence of HDFN in the Malay neonatal population due to clinically significant RBC alloantibodies.
  
  
  METHODS
  A cross sectional study was conducted in Transfusion Medicine Unit, Hospital Universitiy Sains Malaysia over one year period from January to December 2009. A total of 5163 Malay pregnant women who attended labor room for delivery were collected and analyzed prospectively. The blood samples were subjected to the standard immunohematological procedure for RBC antibody screening and identification using reagents of Diamed-ID Gel microtyping system. All the newborns with RBC alloantibody were investigated for the evidence of HDFN.
  
  
  RESULTS
  Thirty (0.58%) women were found to have clinically significant RBC alloantibodies. Most of the alloantibodies belonged to Rhesus (Rh) system (56.7%) where anti-E (33.3%) was the most common followed by anti-D (10.0%). Rh antibodies were the main cause of HDFN in fourteen (0.27%) neonates. Anti-D and anti-c were identified to cause moderate to very severe HDFN.
  
  
  CONCLUSIONS
  With the low prevalence of clinically significant RBC alloantibodies and HDFN, routine antenatal antibody screening practice may not be advised as a routine practice at present, preferably reserved for those women of RhD negative or with history of HDFN, significantly of those attributed to anti-c.
authors.affiliation: Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Mohd Nazri
authors.initials: MN
authors.lastname: Hassan
authors.affiliation: Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Noor Haslina
authors.initials: NH
authors.lastname: Mohd Noor
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Shah Reza
authors.initials: SR
authors.lastname: Johan Noor
authors.affiliation: Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Salamah Ahmad
authors.initials: SA
authors.lastname: Sukri
authors.affiliation: Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia.
authors.forename: Rapiaah
authors.initials: R
authors.lastname: Mustafa
authors.affiliation: Department of Paediatric, School of Medical Sciences, Health Campus, Universiti Sains, Kubang Kerian, Kelantan, Malaysia, Malaysia.
authors.forename: Hans Van Rostenberghe
authors.initials: HV
authors.lastname: Luc Aster
keywords: Clinically significant alloantibodies; HDFN; Malay