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Published on: January 2, 2013
Non-specific red cell reactivity in an obstetric population
Kristi R Van Winden1, Jessica L Poisson2, Richard H Lee1
1a Department of Obstetrics and Gynecology , Division of Maternal-Fetal Medicine, Keck School of Medicine, University of Southern California , Los Angeles , CA , USA .
Objective:
To examine non-specific red cell reactivity (NSR) on antibody (Ab) screening of obstetric inpatients.
Methods:
Observational study of 5438 obstetric inpatients (2009-2013). Ab-positive patients were identified and their records reviewed for NSR, other antibodies, transfusion reactions or hemolytic disease of the fetus/newborn (HDFN). Evaluation of NSR frequency by test era assessed the impact of an institutional change to solid-phase screening in 2011.
Results:
Of obstetric inpatients, 5.3% had at least one positive Ab screen; 1.6% had NSR. Of NSR-positive patients, 16.7% had identifiable Abs that pre-dated NSR; 25% had concurrent Abs and 8.5% had subsequent Ab identification. In 49.1%, NSR resolved during follow-up. The frequency of NSR was higher after the change to solid-phase Ab screening, but specific Ab frequency was similar in both testing periods. No transfusion reactions or cases of HDFN were noted in this cohort.
Conclusions:
NSR is found in 1-2% of obstetrical inpatients at our institution, and has more than doubled since the initiation of solid-phase screening. Although likely clinically insignificant by itself, NSR is commonly found in relation to other red cell Abs and may precede their development.
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