在怀孕期间临床显著的红细胞抗体血清转化率
Jia Jennifer Ding1, Elizabeth Abels2, Jeremy W Jacobs3
1Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
概括
在怀孕期间临床显著的红细胞 (RBC) 抗体血清转化是罕见的,发生在0.26%的分娩中. 先进的孕产妇年龄和更高的怀孕/平行率是危险因素,但常规的第三个三个月查可能不需要.
科学领域:
- 产科和妇科 产科和妇科
- 输血医学 输血医学
- 免疫学 免疫学 免疫学
背景情况:
- 怀孕期间红细胞 (RBC) 的非免疫化可以导致胎儿和新生儿 (HDFN) 的溶血性疾病.
- 了解红细胞抗体血清转化发生率和风险因素对于优化产前护理至关重要.
研究的目的:
- 为了确定在怀孕期间临床显著的RBC抗体血清转换的发生率.
- 为了确定相关的孕产妇风险因素和新生儿后果.
- 评估是否需要进行常规的第三季度抗体查.
主要方法:
- 从2016年7月到2023年3月,对71,384次分娩的回顾性队列研究.
- 基于红细胞抗体状态的怀孕分类:不显著,先前与免疫接种或血清转化.
- 在血清转化怀孕中分析母亲的特征,风险因素和新生儿结局 (血红蛋白,输血需求,NICU入院).
主要成果:
- 临床显著的红细胞抗体血清转化率为0.26% (176/67,570次分娩).
- 之前接受过免疫接种的孕妇占0.27% (185/67,570).
- 先进的孕产妇年龄,增加的怀孕,和平价与血清转化有显著的关联.
- 在血清转化妊娠中新生儿结局包括1.7%的低血红蛋白,2.2%需要输血 (与HDFN无关) 和19.1%的NICU入院.
结论:
- 在怀孕期间临床显著的RBC抗体血清转化不常见 (0.26%).
- 在血清转化妊娠中,没有死产或新生儿死亡被归因于RBC配免疫.
- 鉴于发病率较低,可能不适合在第三个三个月进行常规的红细胞抗体产前查.
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