Non-RhD alloimmunization in pregnancy: an updated review.

Area of Science:

• Immunology
• Obstetrics
• Transfusion Medicine

Background:

• RhD alloimmunization remains the leading cause of hemolytic disease of the fetus and neonate (HDFN).
• Current prevention strategies predominantly target anti-RhD antibodies, potentially overlooking other significant red blood cell antigens.
• The proportion of HDFN cases attributed to non-RhD antibodies is increasing.

Purpose of the Study:

• To review and list major red blood cell antigen groups beyond RhD implicated in HDFN.
• To discuss the clinical importance, global prevalence, and recommended management for antibodies against these antigens during pregnancy.

Main Methods:

• Literature review of red blood cell antigen groups associated with HDFN.
• Analysis of clinical significance, prevalence data, and management guidelines for relevant antibodies.

Main Results:

• Identified key red blood cell antigen systems including Rh, ABO, Kell, MNS, Duffy, and Kidd.
• Detailed the clinical impact and epidemiological variations of antibodies against these antigens.
• Summarized recommended diagnostic and management approaches for pregnant individuals with these antibodies.

Conclusions:

• While RhD alloimmunization is primary, other red blood cell antibodies pose a growing risk for HDFN.
• Comprehensive screening and management protocols are necessary to address the increasing incidence of non-RhD related HDFN.
• Understanding the prevalence and clinical significance of various red blood cell antigens is crucial for effective prenatal care.