Maternal antibody screening revealed that 4.8% of pregnant women carried irregular red cell antibodies that could cause hemolytic disease of the fetus and newborn (HDFN), underscoring the importance of routine testing, according to a study published recently in Transfusion and Apheresis Science.
These antibodies, if undetected, can trigger complications including neonatal jaundice, anemia, and in severe cases, life-threatening illness for newborns. Researchers at Gwarimpa General Hospital in Abuja, Nigeria, examined 250 pregnant women aged 16 to 45 years over a six-month period.
The most frequently identified antibody was anti-E, found in 1.2% of participants. Anti-K followed at 0.8%, while anti-C and anti-Jsb were each detected in 0.4%. All antibodies appeared among women who were Rh D positive.
This study highlighted that even women with the same ABO and Rh blood type as their potential transfusion donor were not always safe matches. A blind crossmatch showed that 5 of 250 samples (2.0%) were incompatible, despite identical grouping, emphasizing that hidden antibodies can make blood transfusions risky without proper screening.
Read more about testing and diagnosis for HDFN
Efficiency and safety of the antibody screening methods were limited, with sensitivity at 41.6% and efficiency at 48.6%. Still, the tests successfully flagged antibodies that could otherwise remain unnoticed, giving clinicians vital information to protect mothers and infants. Compared with developed countries, where irregular antibody rates are as low as 0.5% in Sweden, the 4.8% prevalence in this Nigerian population was higher but lower than reports from some other developing regions.
The majority of participants were in their second trimester, and most had had two pregnancies. A history of miscarriage or abortion was reported in 40% of women, and 11.2% said they had previously delivered newborns with jaundice, a hallmark of HDFN.
“The implication of this finding is that the 11.2 %of previous neonatal jaundice reported by the pregnant women in this study may obviously be due to non-Rh D antibodies which were not investigated,” explained the authors of this study. They continued, “This calls for urgent need in the change of policy in immune-haematological care of pregnant women in this locality.”
Blood group distribution showed group O Rh positive was most common, followed by group A Rh positive.
For patients, these results underscore that antibody screening during pregnancy can help prevent undetected risks to babies. Identifying antibodies such as anti-E and anti-K allows health workers to anticipate and manage complications before delivery, improving outcomes for both mother and child.
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