Journal article
Associations of Rhesus and non-Rhesus maternal red blood cell alloimmunization with stillbirth and preterm birth
International journal of epidemiology, v 43(4), pp 1123-1131
Aug 2014
PMID: 24801308
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background:
Although the risks of adverse pregnancy outcomes associated with anti-D antibodies are well-recognized, much less is known concerning alloimmunization with other red blood cell antibodies detected during routine maternal screening. To date, most reports of adverse pregnancy outcomes associated with non-anti-D antibodies have been from small case studies. The aim of this study was to examine the associations of maternal alloimmunization with specific red blood cell antibodies and the risks of preterm birth and stillbirth in the Swedish population.
Methods:
All antibody screening, outcome and covariate data were obtained through linkages of Swedish national health and data registers. Follow-up in these population-based registers was available up to 31 December 2002. The final study sample consisted of 1 022 569 singleton births from 668 952 mothers during 1987–2002.
Results:
In total, 1.3% of the 1 022 569 study pregnancies were alloimmunized. In adjusted logistic regression models, compared with having no antibodies, alloimmunization with anti-D, anti-E, anti-C and anti-c was associated with increased risk of both stillbirth and preterm birth. In addition, anti-Kell was associated with increased risk of preterm birth and anti-Lea with increased risk of stillbirth. Compared with firstborn children, risk of preterm birth associated with alloimmunization was greater in subsequent births
Conclusions:
In the largest study to date, alloimmunization with Rhesus, K- and -Lea red blood cell antibodies increased the risk of preterm birth and/or stillbirth. The association of anti-Lea with stillbirth was an unexpected finding. Further study of the consequences of non-anti-D alloimmunization is warranted.
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Details
- Title
- Associations of Rhesus and non-Rhesus maternal red blood cell alloimmunization with stillbirth and preterm birth
- Creators
- Jing Fan - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, SwedenBrian K Lee - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, SwedenAgneta T Wikman - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, SwedenStefan Johansson - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, SwedenMarie Reilly - Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden
- Publication Details
- International journal of epidemiology, v 43(4), pp 1123-1131
- Publisher
- Oxford University Press
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000343935200019
- Scopus ID
- 2-s2.0-84905669274
- Other Identifier
- 991014877797604721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health