Red Cell Alloimmunization and Antibody Specificity in Multigravida Attending Antenatal Clinic at Tertiary Care Centre from Rohilkhand Region

Abstract

Introduction: Red cell alloimmunization is an immune
response to foreign red cell antigens which can occur due to
transfusion between a donor and recipient, during pregnancy
between mother and fetus and also in transplant recipients.
Such disparity may result in transfusion reactions or may be
associated with hemolytic disease of the fetus and newborn.
The current study was undertaken to observe the prevalence
of red cell alloimmunization and antibody specificity in
multigravida patients with respect to epidemiological (age),
obstetrical, major blood group systems and transfusion-related
parameters.
Material and Methods: This prospective cross-sectional study
was conducted over a period of 1.5 years from October 2018 to
April 2020, in the patients at risk of exposure to foreign red cell
antigens in multigravida patients, in the blood bank of tertiary
care medical institute of North India.
Antibody screening and identification was performed on 1055
multigravida females using commercially prepared O cells
(IMMUCOR, USA). Statistical evaluation by Chi-square test
was performed wherever applicable. p-value of <0.05 was
considered statistically significant at 95% confidence interval.
Results: Prevalence of red cell alloimmunization in
multigravida females was 1.99% with anti-D being the most
common antibody identified. Other less commonly detected
alloantibodies were anti-E, anti-Jkb (Kidds) and anti-Kpa (Kell).
A statistically significant association was found between red cell
alloimmunization and increase in gravida status, presence of
bad obstetric history, age (>30 years) and Rh-D status. When
compared with other independent variables such as parity
and ABO blood group of the female, no statistical significant
association was observed.
Conclusion: Maternal alloimmunization is associated with
anti-D specificity and antibodies against other clinically
significant minor blood group antigens such as anti-E and
anti-Jkb (Kidd) and anti-Kpa (Kell). Routine antibody screeningof
all antenatal females, irrespective of the Rh-D status must
be adopted by health care system for detection of clinically
significant antibodies that may be associated with HDFN or
delayed hemolytic transfusion reaction.