Maternal anti-D prophylaxis during pregnancy and risk of hemolysis among preterm infants

J Perinatol. 2014 Dec;34(12):906-8. doi: 10.1038/jp.2014.134. Epub 2014 Jul 24.

Abstract

Objective: To evaluate whether Rh-positive preterm newborn infants born to Rh-negative mothers treated with prophylactic anti-D immunoglobulins exhibited signs of hemolytic reaction, including anemia and hyperbilirubinemia.

Study design: Retrospective data were collected for 94 Rh-positive preterm newborns born at gestational age (GA) 28 to 34 weeks to 76 Rh-negative mothers and for matched controls.

Result: We found 11.7% positive Coombs' tests among infants in the study group and slightly higher bilirubin levels at birth and on the following 3 days. No differences were recorded between the study and the control groups for hematocrit levels throughout hospitalization, maximal bilirubin level, phototherapy treatment or the need for blood transfusion.

Conclusion: Among preterm Rh-positive newborn infants born to Rh-negative mothers, there appears to be no evidence of significant hemolytic reaction derived from placental anti-D transfer. Further prospective studies are needed to confirm these findings in order to support anti-D administration close to preterm birth.

MeSH terms

  • Adult
  • Bilirubin / blood
  • Coombs Test
  • Erythroblastosis, Fetal / prevention & control
  • Female
  • Hematocrit
  • Hemolysis / drug effects*
  • Humans
  • Infant, Newborn
  • Infant, Premature*
  • Logistic Models
  • Male
  • Pregnancy
  • Pregnancy Outcome
  • Rho(D) Immune Globulin / therapeutic use*

Substances

  • Rho(D) Immune Globulin
  • Bilirubin