Determining fetal RhD status early in RhD-negative pregnancies could help prevent the unnecessary administration of anti-D immunoglobulin to reduce hemolytic disease of the fetus and newborn (HDFN) risk, thereby avoiding over-treatment in some cases, according to a recently published study in Scientific Reports.
Pregnancies in which the mother is RhD-negative are at increased risk of complications related to HDFN. However, this risk is essentially absent if the fetus is also RhD-negative.
Anti-D immunoglobulin is commonly administered to prevent RhD sensitization in RhD-negative pregnancies and reduce the risk of HDFN in future pregnancies. Although severe adverse reactions are rare, they are possible, and there is growing interest in minimizing unnecessary treatment.
Therefore, the authors aimed to evaluate the usefulness of their non-invasive method for determining fetal RhD status by analyzing the frequency of RhD-negative pregnancies and anti-D immunoglobulin administration practices in Japan.
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During the study period, the authors identified 1,088 RhD-negative pregnancies among the 150,000 pregnancies that occurred at participating centers. Among 1,091 newborns (including twins), 95 (8%) were RhD-negative and 996 were RhD-positive.
“This indicates that approximately one in 11 RhD-negative pregnant women receive unnecessary anti-D immunoglobulin during pregnancy,” the authors wrote.
Approximately 96% of the women included in the study received anti-D immunoglobulin during pregnancy. The authors noted two cases in which it was incorrectly administered, as the mothers had already been sensitized.
Postnatal anti-D immunoglobulin administration was observed in 89% of cases. Researchers detected two instances in which administration occurred despite the newborn also being RhD-negative.
Regarding differences between previously sensitized and unsensitized mothers, the authors observed a higher risk of complications such as preterm delivery and HDFN in sensitized pregnancies.
“Despite the low incidence of RhD-negative pregnancies, this study underscores the need for tailored management strategies. Non-invasive prenatal diagnosis of fetal RhD status could help prevent unnecessary anti-D immunoglobulin administration, improving both outcomes and resource utilization in Japan,” the authors concluded.
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