Distribution of Maternal Red Cell Antibodies and the Risk of Haemolytic Disease of the Foetus and Newborn in Sokoto Nigeria

Abstract

Background: The incidence is still of clinical importance because sensitization of the mother may occur through the placenta, blood transfusion, miscarriage, ectopic pregnancy, amniocentesis as well as lack of prophylaxis of alloantibody except RhD. Aim: The aim of this study is to determine the prevalence of clinically significant red blood cell alloantibodies among pregnant women. Study Design: This was a cross- sectional study. Duration of Study: The study lasted for a period of one year between January to December, 2021. Methodology: About 1250 consecutively recruited pregnant women were screened for alloantibody and identification was done to determine the specificity of the antibody using NHSBT reagent with column agglutination card technology. Results: Among the 1250 apparently healthy pregnant women studied, 73(5.8%) had alloantibodies with specificity as follows: Multiple antibody of C, E 3 (4.1%), D 23 (31.5%), C 6(8.2%), E 5(6.8%), e (1.4%), Jka 2 (2.7%), Jkb 2 (2.7), M 1 (1.4%), S 1 (1.4%), Lea 7 (9.6%), Leb 8 (11%), I 4 (5.5%), and Lu 7 (9.6%).  When the demographic and obstetric characteristics were compared with the presence of alloantibodies, statistically significant differences were observed in gestational age, past history of pregnancy, preeclampsia, and previous baby delivered with jaundice and previous administration of anti-D prophylaxis. Conclusion: There is high prevalence of alloantibody among pregnant women that may be linked to lack of premarital testing to know couple at risk and lack of standard protocol of alloantibody testing.