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• W2014450902 abstract "ObjectiveWe assessed the hypothesis that alloimmunization to multiple red blood cell (rbc) antigens has a more severe impact on perinatal outcomes than alloimmunization to only one antigen.Study designRetrospective cohort study using prospectively collected data in our obstetric database for women receiving prenatal care and giving birth (≥20 weeks gestation) from 1991-2006. Perinatal outcomes among women sensitized to 1 or ≥2 clinically important (able to cause hemolytic disease) rbc antigens were compared to those without sensitization. Logistic regression was used to control for confounding and generalized estimating equations used to account for correlation between births from the same woman.Results177 pregnancies were sensitized to at least one clinically important rbc antigen while 58,883 were unsensitized (screen negative). Among those sensitized, 15.8 % (n=28) involved ≥2 antigens. Baseline risk of stillbirth and neonatal death were 1.2% and 6/1000, respectively, in the unsensitized group and these were not significantly different in any sensitized subgroup. After adjusting for differences in maternal race, parity, drug use and plurality, as well as gestational age and prior preterm birth as applicable, perinatal outcomes were generally worse in the presence of sensitization to two or more antigens as confirmed with tests of heterogeneity (Table).Tabled 1OutcomesPrevalence (%)Adjusted odds ratios (95% CI)None1 only≥2One rbc antigen≥2 rbc antigensPerinatal Phototherapy⁎Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05..2.08.2222.20.7, 6.6298.2, 106 Neonatal transfusion⁎Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05..0.62.5116.41.9, 22399.1, 165 Low birth weight1523411.91.1, 3.22.80.9, 9.0 Preterm birth <37 weeks⁎Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05..1732661.91.2, 3.17.52.7, 21 Preterm birth <35 weeks8.816341.81.0, 3.32.50.7, 9.1 Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05.. Open table in a new tab ConclusionRelative to unsensitized pregnancies, alloimmunization to two or more important antigens is associated with worse perinatal outcomes than is alloimmunization to one only. ObjectiveWe assessed the hypothesis that alloimmunization to multiple red blood cell (rbc) antigens has a more severe impact on perinatal outcomes than alloimmunization to only one antigen. We assessed the hypothesis that alloimmunization to multiple red blood cell (rbc) antigens has a more severe impact on perinatal outcomes than alloimmunization to only one antigen. Study designRetrospective cohort study using prospectively collected data in our obstetric database for women receiving prenatal care and giving birth (≥20 weeks gestation) from 1991-2006. Perinatal outcomes among women sensitized to 1 or ≥2 clinically important (able to cause hemolytic disease) rbc antigens were compared to those without sensitization. Logistic regression was used to control for confounding and generalized estimating equations used to account for correlation between births from the same woman. Retrospective cohort study using prospectively collected data in our obstetric database for women receiving prenatal care and giving birth (≥20 weeks gestation) from 1991-2006. Perinatal outcomes among women sensitized to 1 or ≥2 clinically important (able to cause hemolytic disease) rbc antigens were compared to those without sensitization. Logistic regression was used to control for confounding and generalized estimating equations used to account for correlation between births from the same woman. Results177 pregnancies were sensitized to at least one clinically important rbc antigen while 58,883 were unsensitized (screen negative). Among those sensitized, 15.8 % (n=28) involved ≥2 antigens. Baseline risk of stillbirth and neonatal death were 1.2% and 6/1000, respectively, in the unsensitized group and these were not significantly different in any sensitized subgroup. After adjusting for differences in maternal race, parity, drug use and plurality, as well as gestational age and prior preterm birth as applicable, perinatal outcomes were generally worse in the presence of sensitization to two or more antigens as confirmed with tests of heterogeneity (Table).Tabled 1OutcomesPrevalence (%)Adjusted odds ratios (95% CI)None1 only≥2One rbc antigen≥2 rbc antigensPerinatal Phototherapy⁎Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05..2.08.2222.20.7, 6.6298.2, 106 Neonatal transfusion⁎Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05..0.62.5116.41.9, 22399.1, 165 Low birth weight1523411.91.1, 3.22.80.9, 9.0 Preterm birth <37 weeks⁎Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05..1732661.91.2, 3.17.52.7, 21 Preterm birth <35 weeks8.816341.81.0, 3.32.50.7, 9.1 Test for heterogeneity between 1 and ≥2 rbc is significant at α < 0.05.. Open table in a new tab 177 pregnancies were sensitized to at least one clinically important rbc antigen while 58,883 were unsensitized (screen negative). Among those sensitized, 15.8 % (n=28) involved ≥2 antigens. Baseline risk of stillbirth and neonatal death were 1.2% and 6/1000, respectively, in the unsensitized group and these were not significantly different in any sensitized subgroup. After adjusting for differences in maternal race, parity, drug use and plurality, as well as gestational age and prior preterm birth as applicable, perinatal outcomes were generally worse in the presence of sensitization to two or more antigens as confirmed with tests of heterogeneity (Table). ConclusionRelative to unsensitized pregnancies, alloimmunization to two or more important antigens is associated with worse perinatal outcomes than is alloimmunization to one only. Relative to unsensitized pregnancies, alloimmunization to two or more important antigens is associated with worse perinatal outcomes than is alloimmunization to one only." @default.
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• W2014450902 date "2007-12-01" @default.
• W2014450902 modified "2023-09-23" @default.
• W2014450902 title "523: Impact of alloimmunization to multiple red cell antigens on perinatal outcomes" @default.
• W2014450902 doi "https://doi.org/10.1016/j.ajog.2007.10.525" @default.
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