Maternal red blood cell alloantibodies identified in blood samples obtained from Iranian pregnant women: the first population study in Iran

Background

Alloimmunization of red blood cells in pregnant women is still a challenge to clini cians. Maternal immunoglobulin G anti bodies are the main cause of fetal RBC hemolysis by targeting fetal RBC antigens. we aimed to determine the frequency of alloimmuniza tion in pregnant women who were referred to the Iranian Blood Transfusion Organization. Before 2015 there was no national protocol for testing of pregnant women for the detection and identification of RBC antibodies.

Methods

Thiswasa prospective cross-sectional study, which was carried out in the immunohematology reference laboratory of the Iranian Blood Transfusion Organization in Tehran, Iran, in 2008 to 2015. Screening and identification of red blood cell (RBC) alloantibodies was done on the sera of 7340 pregnant females using the standard tube method and gel column agglutination technique.

Results

Alloantibodies were identified in the serum of 332 of the 7340 (4.5%) pregnant women. A total of 410 antibodies were detected in 332 positive maternal serum samples with no previous history of blood transfusion. Anti-D was the most common antibody accounting for 70.5% of all the antibodies formed in D– women. The incidence of specific alloimmunization other than Rh group was 14.4%.

Conclusion

In Iran, like other developing countries, alloimmunization screening tests are performed only to detect anti-D in pregnant D– women. This high rate of alloimmunization, quite possibly, is due to the fact that the majority of blood samples came from pregnant womenknownto have previous obstetric problems. However, we suggest that RBC antibody screening tests should be extended to all D1 women.

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