Severe neonatal hemolysis due to a maternal antibody to the low-frequency Rh antigen C(w)

Julie May-Wewers1, Jeffrey R Kaiser, Ellen Kay Moore

  • 1Department of Pediatrics, UAMS College of Medicine, Little Rock, Arkansas 72202-3591, USA.

C(w) is a low-frequency antigen in the Rh blood group system with a prevalence of approximately 2% in whites. Although anti-C(w) is not an uncommon antibody in pregnancy (0.1% incidence), clinically significant hemolytic disease of the newborn is highly unusual. We report the case of an infant with severe hyperbilirubinemia and persistent anemia due to a high-titer maternal C(w) antibody. The medical literature relating to maternal C(w) alloimmunization and neonatal outcome is also reviewed. In addition, recommendations are made regarding the management of pregnancies and newborns complicated by antibodies to C(w).

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