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Incidence of Rh immunization between 1981 and 1992
1Institute of Immunohaematology (ICMR), Maharashtra, India.
The National Medical Journal of India
|March 1, 1994
Summary
Rh immunization rates in pregnant women significantly declined between 1981 and 1992, possibly due to family planning and anti-D immunoglobulin use. Continued efforts are needed for complete eradication of Rh hemolytic disease of the newborn.
Area of Science:
- Obstetrics and Gynecology
- Immunohaematology
- Perinatal Medicine
Background:
- The Rh clinic at Nowrosjee Wadia Maternity Hospital has monitored Rh immunization since 1957.
- Historically, 5% of Rh-negative women developed Rh antibodies, a rate reduced to 3.3% by 1978-1980.
Purpose of the Study:
- To determine the incidence of Rh immunization among antenatal women between 1981 and 1992.
- To analyze trends in Rh immunization rates over a 12-year period.
Main Methods:
- Standard ABO and Rh grouping performed on 139,635 antenatal samples.
- Screening of 6,914 Rh-negative women for Rh antibodies using an enzyme technique.
- Data analyzed in four 3-year intervals to assess temporal changes.
Main Results:
- Rh-negativity frequency remained stable at approximately 5%.
- Rh immunization rate in Rh-negative women decreased from 3.1% (1981-83) to 1.7% (1990-92).
- Significant decline in Rh immunization incidence among all pregnant women (0.16% to 0.09%) and a rise with increasing parity (0.4% to 17.5% after four+ pregnancies).
Conclusions:
- Rh immunization incidence has declined over 12 years, likely due to family planning and anti-D immunoglobulin use.
- Complete eradication of Rh hemolytic disease of the newborn requires a comprehensive Rh prophylaxis program.