Despite a significant decrease in mortality in patients with hemolytic disease of the fetus and newborn (HDFN), a significant need for transfusions and other forms of treatment after birth remains, according to a recently published study in BMC Pregnancy Childbirth.
HDFN is a disease in which maternal antibodies bind to the red blood cells of the fetus, causing their destruction, which in turn leads to anemia and the accumulation of bilirubin, a molecule capable of causing permanent neurological damage in newborns when in excess.
Advances in prenatal monitoring and the introduction of specific preventive treatments, such as the introduction of Rh(D) immunoprophylaxis (RhIG) as well as intrauterine transfusions, have improved the prognosis of the disease.
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“Even though advances have been made, much is still unknown on the exact frequency of the need for postnatal treatment and the clinical outcomes of these affected neonates,” the authors wrote.
The authors aimed to conduct a review of several studies regarding the subject to paint a more accurate picture of the current landscape of HFDN. After an extensive search and selection process using renowned medical databases, the authors analyzed 60 studies of patients with HDFN.
The review of the selected studies showed that the need for blood transfusions in newborns with HDFN remains high, with over 60% of cases requiring some form of transfusion. The authors could not find enough information regarding the frequency of adverse effects associated with transfusions.
The authors observed that the transfusion rate varied significantly among centers and countries. In light of these findings, the authors recommend future studies focus on assessing the differences among HDFN management strategies among countries.
“In summary, we found that, although the neonatal mortality rate is nowadays low, the postnatal clinical burden of Rh(D)- and/or K-mediated HDFN remains relatively high, with a high need for exchange transfusions and simple RBC transfusions,” the authors concluded.
