Frequency of Red Cell Alloantibodies among Pregnant Women Receiving Antenatal Care in a Tertiary Health Facility in Jos, Nigeria
Asian Hematology Research Journal,
Page 192-201
Abstract
Aims: To determine the frequency of red blood cell alloantibodies among pregnant women in Jos, Nigeria.
Study Design: A cross sectional study was carried out among pregnant women accessing antenatal care.
Place and Duration of Study: The study was conducted at Department of Obstetrics and Gynaecology and Department of Haematology and Blood Transfusion, Jos University Teaching Hospital (JUTH) Jos, Nigeria from 24th April 2017 to 31st May 2017.
Methodology: We included 200 pregnant women accessing antenatal care. Data on clinical details were obtained with an Interviewer-administered questionnaire. Screening and identification of red blood cell alloantibodies were made using the DiaCells, and DiaPanels (DiaMed GmbH, Switzerland). ABO and Rh blood groups were done using antisera from Biotec (Ipswich, UK).
Results: Out of 200 participants, alloantibodies were found in 24 (12.0%) of participants and their specificities were as follows; anti-E, 9 (4.5%); anti- e, 1 (0.5%); anti-C, 6 (3.0%); anti- c, 2 (1.0%); anti- K, 2 (1.0%); anti- P, 1 (0.5%); anti- N, 1 (0.5%), while 2 (1.0%) showed a combination of antibodies of whose specificities could not be determined by the Diamed 11-panel cells. Multigravidity was identified as a risk factor for alloimmunization (P= 0.01). However, alloimmunization status was independent of previous abortions, trimester of pregnancy, and ABO blood group of the studied population.
Conclusion: Alloantibody screening and identification is should be included in routine antenatal care, especially for at-risk populations.
Keywords:
- Alloimmunization
- antenatal
- Jos
- Nigeria
- red blood cells
- alloantibodies
How to Cite
Chinedu, N. O., Obadiah, D. D., Salawu, L., Ezra, D. J., Jasini, J., Amandy, O. O., & Charity, I. O. (2023). Frequency of Red Cell Alloantibodies among Pregnant Women Receiving Antenatal Care in a Tertiary Health Facility in Jos, Nigeria. Asian Hematology Research Journal, 6(4), 192-201. Retrieved from https://journalahrj.com/index.php/AHRJ/article/view/30234
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Gajjar, K, Spencer C. Diagnosis and management of non-anti-D red cell antibodies in pregnancy. The Obstetrician and Gynaecologist. 2009;11:89- 95.
Thompson S, Eggington J, Dodd A, Qureshi R, Turner E. Late developing red cell antibodies in pregnancy. Transfusion Medicine. 2003;13:8- 9.
Thakur B, Kaushik S, Kishore S, Kumar R, Rajput A. 2016. ABO/Rh distribution pattern and prevalence of irregular antibodies in healthy blood donors of Uttarakhand. Journal of Evolution of Medical and Dental Sciences. 2016;5: 3852-3856.
Devi SA, Alwar VA, Sitalakshmi S, Ramesh Kumar K, Mhaskar R. Red blood cell antibody screening in pregnancy. Asian Journal of Transfusion Science. 2011;5:56.
Webert KE, Smith JW, Arnold DM, Chan HHW, Heddle NM, Kelton JG. Transfusion Medicine; Red Cell, Platelet, and White Cell Antigens. In: Greer JP, Arber DA, Glader B, List AF, Means RT (eds). Wintrobe’s Clinical Hematology. 13th edition. Lippincott Williams and Wilkins, Philadelphia. 2014;1193- 1273.
Erhabor O, Kabiru SA, Abdulrahaman Y, Okwesili A, Onuigwe F, Isaac ZI. Rh (E) phenotype among pregnant women in Sokoto, North Western Nigeria. American Journal of PharmTech Research. 2014; 4:84- 92.
Erhabor O, Okwesili A, Aliyu BS, Onuigwe F, Buhari H, Bagudo A . Prevalence of rhesus c and e Phenotype among pregnant women attending antenatal clinic In Usmanu Danfodiyo University Teaching Hospital, Sokoto. Journal of Gynecology and. Neonatal Biology. 2016;2:13-16.
Giblet ER. Blood group alloantibodies: An assessment of some laboratory practice. Transfusion. 1997;17: 29-308.
Prinzena L, Staalb HM, Rouwettea SJM, Beckersc EAM, ten Broekeb RHM, van Rhijnb LW. Triple red blood cell alloantibody formation after bone-allograft transplantation. American Journal of Transplantation. 2013;13:229-231.
Lappen JR, Stark S, Gibson KS, Prasad M, Bailit JL. Intravenous drug use is associated with alloimmunization in pregnancy. American Journal of Obstetrics and Gynecology. 2016;214: 399- 400.
British Committee for Standards in Haematology. Guidelines for blood grouping and red cell antibody testing during pregnancy. Jul 2008. www.bcshguidelines.org.
Adias TC, Erhabor O. Suboptimal testing for alloantibodies in sub-Saharan Africa: Bane to effective Immunohaematological services delivery. International Journal of Medical Sciences and Health Care. 2013; 1:13- 22.
Santavy J. Haemolytic disease in the newborn - history and prevention in the world and the Czech Republic. Biomedical Papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia. 2010;154:147– 151.
Liumbruno GM, D’Alessandro A, Rea F, Piccinini V, Catalano L, Calizzani G. The role of antenatal immunoprophylaxis in the prevention of maternal - foetal anti- Rh(D) alloimmunization. Blood Transfusion. 2010;8:8–16.
Velati CA. survey of the current use of anti-D immunoprophylaxis and the incidence of haemolytic disease of the newborn in Italy. Blood Transfusion. 2007;5: 7–14.
Moise KJJ. Non-anti-D antibodies in red-cell alloimmunization. European Journal Obstetrics and Gynecology and Reproductive Biology. 2000; 92:75 –81.
Toma BO, Ige OO, Abok II, Onwuanaku C, Abah RO, Donli A. Pattern of neonatal admissions and outcome in a tertiary institution in north central Nigeria. Journal of Medicine in the Tropics. 2013;15:121‑125.
Varghese J, Chacko MP, Rajaiah M, Daniel D. Red cell alloimmunization among antenatal women attending a tertiary care hospital in south India. Indian Journal of Medical Research. 2013; 138: 68–71.
Erhabor O, Isaac Z, Yakubu A, Adias TC. Abortion, ectopic pregnancy and miscarriages in Sub Saharan Africa: Challenges of Rhesus isoimmunisation in Rhesus negative women. Open Journal of Obstetrics and Gynaecology. 2013;3: 15-26.
Patel J, Shukla R, Gupte S. Red Cell alloimmunization in multitransfused patients and multiparous women. Indian Journal of Hematology and Blood Transfusion. 2009;25:49-52.
Pahuja S, Gupta SK, Pujani M, Jain M. The prevalence of irregular erythrocyte antibodies among antenatal women in Delhi. Blood Transfusion. 2011;9:388-93.
Koelewijn JM, Vrijkotte TG, van der Schoot CE, Bonsel GJ, de Haas M. Effect of screening for red cell antibodies, other than anti-D, to detect hemolytic disease of the fetus and newborn: A population study in the Netherlands. Transfusion. 2008;48: 941- 952.
Al-Ibrahim NA, Al Saeed AH. Red blood cell alloimmunisation among Saudi pregnant women in the central province of Saudi Arabia. Kuwait Medical Journal. 2008;40:116- 123.
Gottvall T, Filbey D. Alloimmunization in pregnancy during the years 1992-2005 in the central west region of Sweden. Acta Obstetricia et Gynecologica Scandinavica. 2008;87:843- 848.
Jeremiah ZA, Mordi A, Buseri FI, Adias TC. Frequencies of maternal red blood cell alloantibodies in Port Harcourt. Nigeria Asian Journal of Transfusion Science. 2011;5:39- 41.
Jeremiah ZA, Mordi A. Evaluation of the clinical utility of maternal alloantibody screening as a surrogate to antiglobulin cross matches procedures in resource-limited settings. International Journal of Blood Transfusion and Immunohematology. 2011;1:1 -6.
Adewoyin AS, Adeyemi O, Ande AB, Awodu OA. Immune erythrocyte alloantibodies among pregnant women attending an antenatal clinic in a tertiary health facility, Benin City, Nigeria. J Appl Hematol. 2023;14:1-6.
Araoye MO. Sample size determination. In: Araoye MO ed. Research Methodology with Statistics for Health and Social Sciences: Nathadox, Ilorin. 2004;115‒122.
Bashawari LAM. Red cell alloimmunization in sickle cell anaemia. Eastern Mediterranean Health Journal. 2007; 13:5.
Isaac IZ, John RT, Imoru M, Udomah FP, Erhabor O, Ango IG. Effect of previous stillbirth on the formation of alloantibody among women in Sokoto Tertiary Hospital. Asian Journal of Medicine and Health. 2016;1:1- 8.
Daniels G, Contreras M, Allard S. Red cell Immunohaematology. In: Hoffbrand VA, Higgs RD, Keeling MD, Mehta AB (eds). Postgraduate Haematology. 7th edition. Wiley- Blackwell, London 2016;195- 213.
Gajjar, K, Spencer C. Diagnosis and management of non-anti-D red cell antibodies in pregnancy. The Obstetrician and Gynaecologist. 2009;11:89- 95.
Thompson S, Eggington J, Dodd A, Qureshi R, Turner E. Late developing red cell antibodies in pregnancy. Transfusion Medicine. 2003;13:8- 9.
Thakur B, Kaushik S, Kishore S, Kumar R, Rajput A. 2016. ABO/Rh distribution pattern and prevalence of irregular antibodies in healthy blood donors of Uttarakhand. Journal of Evolution of Medical and Dental Sciences. 2016;5: 3852-3856.
Devi SA, Alwar VA, Sitalakshmi S, Ramesh Kumar K, Mhaskar R. Red blood cell antibody screening in pregnancy. Asian Journal of Transfusion Science. 2011;5:56.
Webert KE, Smith JW, Arnold DM, Chan HHW, Heddle NM, Kelton JG. Transfusion Medicine; Red Cell, Platelet, and White Cell Antigens. In: Greer JP, Arber DA, Glader B, List AF, Means RT (eds). Wintrobe’s Clinical Hematology. 13th edition. Lippincott Williams and Wilkins, Philadelphia. 2014;1193- 1273.
Erhabor O, Kabiru SA, Abdulrahaman Y, Okwesili A, Onuigwe F, Isaac ZI. Rh (E) phenotype among pregnant women in Sokoto, North Western Nigeria. American Journal of PharmTech Research. 2014; 4:84- 92.
Erhabor O, Okwesili A, Aliyu BS, Onuigwe F, Buhari H, Bagudo A . Prevalence of rhesus c and e Phenotype among pregnant women attending antenatal clinic In Usmanu Danfodiyo University Teaching Hospital, Sokoto. Journal of Gynecology and. Neonatal Biology. 2016;2:13-16.
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