There appears to be a low rate of hemolytic disease of the fetus and newborn (HDFN) prophylaxis with Rh immunoglobulin (RHIG) among Rh-negative pregnant women in India, indicating a possible lack of awareness about the disease, according to a recently published study in the Journal of South Asian Federation of Obstetrics and Gynaecology.
“Rh disease has serious consequences, ranging from fetal anemia to fetal mortality, but is easily preventable with the timely and appropriate administration of anti-D prophylaxis,” the authors wrote.
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Despite recent advances in the screening, diagnosis and prevention of Rh-mediated HDFN, approximately 276 newborns per 100,000 births are affected in developing countries. Recent data from India suggest limited awareness of the risks associated with Rh-negative pregnancies among mothers.
To address this issue, the authors collected extensive data on Rh-negative pregnancies across the country to better inform health policy. The study aims to include data from 20,000 Rh-negative pregnancies; results from this second interim analysis include data from 3,745 pregnancies.
The mean age of participants was 26 years. The most common blood type was type B, followed by type A. Results showed that although over 80% of the women had Rh-positive partners, many had not undergone Rh-sensitization screening nor received adequate follow-up or care. Additionally, 17% of participants reported having had at least one previous abortion.
Alarmingly, less than half of the participants reported receiving RHIG during their current or past pregnancies. Fewer than one-third of patients who had experienced abortions received RHIG prophylaxis.
Approximately 3% of the babies born to the study population experienced complications at birth requiring ventilation and/or blood transfusions. Testing revealed that around 3.5% of the mothers in the study were Rh sensitized, meaning they carried antibodies capable of crossing the placenta and causing HDFN.
“Our study highlights the need to educate both physicians and patients about anti-D prophylaxis and its benefits,” the authors wrote. “This could also inform public health policy for managing Rh-negative pregnancies in India, potentially reducing rates of maternal and fetal complications in this population.”
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