Use of anti-D immunoglobulin during pregnancy for prevention of hemolytic disease in fetus and newborn

Objective To analyze the value of anti-D immunoglobulin in the prevention of hemolytic disease in fetus and newborn. Methods From January 1,2010 to December 31,2017,104 Rh (D)-negative parturients admitted to the First Affiliated Hospital of Chongqing Medical University,the First People's Hospital of Neijiang City or West China Second Affiliated Hospital,Sichuan University/West China Women and Children's Hospital were included in this study.They were divided into anti-D immunoglobulin group (n=51) and control group (n=53) according to whether they were injected with anti-D immunoglobulin or not.The differences in pregnancy outcomes between the two groups were compared,including the production rate of anti-D antibody,the incidence of neonatal hemolysis,the premature delivery rate,the admission rate of neonatal intensive care unit,birth weight,transcutaneous bilirubin level and so on. Results Of the 104 Rh (D)-negative parturients,3 cases (5.88%,3/51) produced antibodies in the anti-D immunoglobulin group,while 14 cases (26.42%,14/53) produced antibodies in control group,and the difference was statistically significant (P=0.01).The level of transcutaneous bilirubin was 9.53±2.32 mg/dl in the anti-D immunoglobulin,significantly lower than 12.62±4.82 mg/dl in the control group (P=0.04).The incidences of neonates transferred to neonatal intensive care unit (7.84%4/51 vs 32.08%17/53),and premature delivery (1.96%1/51 vs 13.20%7/53) in the anti-D immunoglobulin group were significantly higher than those in the control group (P<0.05,respectively).There was no significant difference in neonatal sex,gestational age,birth weight,Apgar score and blood transfusion treatment between the two groups (P>0.05). Conclusion The results show that anti-D immunoglobulin decrease the production rate of anti-D antibody,the incidence of hyperbilirubinemia in neonates,the premature delivery and the rate of neonates transferred to NICU in Rh (D)-negative pregnant women.