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Maternal sickle cell anemia and neonatal isoimmunization
1Specialty Services Division, Saudi-Aramco - Al-Hasa Health Center, Mubarraz, Saudi Arabia. hassibnarchi@hotmail.com
Summary
Pregnant women with sickle cell disease (SCD) face a high risk of alloimmunization, and their infants have an increased risk of isoimmunization, though significant neonatal complications are rare.
Area of Science:
- Hematology
- Obstetrics
- Neonatology
Background:
- Sickle cell disease (SCD) affects red blood cells, increasing risks during pregnancy.
- Alloimmunization and isoimmunization are potential complications in pregnancies involving SCD.
Purpose of the Study:
- To investigate the incidence of alloimmunization in pregnant women with SCD.
- To assess the risk of isoimmunization in neonates born to mothers with SCD.
Main Methods:
- A comparative study involving 30 mothers with SCD and their 35 neonates (group 1).
- Comparison group included 538 infants of mothers without hemoglobinopathies (group 2).
Main Results:
- Six mothers with SCD (20% risk) developed alloantibodies, unrelated to age, parity, or transfusions.
- Six neonates (higher incidence than controls) experienced isoimmunization, primarily ABO incompatibility.
- Affected neonates showed reticulocytosis and jaundice, requiring phototherapy; no transfusions were needed.
Conclusions:
- Alloimmunization is frequent in pregnant women with SCD, and isoimmunization occurs in their offspring.
- Non-ABO alloantibodies were rarely the cause of these conditions.
- Neonatal morbidity associated with isoimmunization was not significant in this study.