Perinatal outcomes in RhD-negative pregnant women in Japan
Year: 2025
Type: article
Study design: Observational Study
Abstract: Managing RhD-negative pregnancies is vital for preventing hemolytic disease of the fetus and newborn, which occurs when RhD-negative mothers develop anti-D antibodies after exposure to RhD-positive fetal blood. This retrospective cohort study evaluated the proportion of RhD-negative pregnancies and newborns in Japan by assessing current management practices and outcomes. This study included RhD-negative pregnant women who delivered at 22 weeks or later at 47 Japanese facilities between April 2018 and March 2023. Pregnancies with unknown newborn RhD status were excluded. Data were obtained from medical records. Among the 1088 RhD-negative women, 1062 met the inclusion criteria. RhD-negative pregnancies comprised 0.71% of the total cohort, with 8.7% RhD-negative newborns. Anti-D immunoglobulin was administered in 96.5% of pregnancies, with a maternal spontaneous sensitization rate of 0.6% before 28 weeks and no sensitization detected from 28 weeks to postpartum. Sensitized RhD-negative women had higher cesarean section, preterm delivery, and neonatal hemolytic anemia rates than the non-sensitized group, leading to increased neonatal intensive care unit admissions. Despite the low incidence of RhD-negative pregnancies, this study underscores the need for tailored management strategies, suggesting that non-invasive prenatal diagnosis of fetal RhD status could prevent unnecessary anti-D immunoglobulin administration, improving outcomes and resource utilization in Japan.
Source: Scientific Reports
Authors: Ken Takahashi, Susumu Yoshida, Showa Aoki, Saori Tanaka, Akihiro Kawashima, Kazuhiro Kajiwara, Noriko Kato, Hitoshi Matsui, Mariko Serizawa, Shunichiro Tsuji, Tomoko Yamamoto, Tadatsugu Kinjo, Noriyuki Nakamura, Maiko Sagawa, Mika Sato, Emiko Abe, Sayuri Nakanishi, Yoshinobu Fujimoto, Sota Takahashi, Hiroyuki Sasaki, Yurika Mukai, Sumiko Hara, Kaori Fukuta, Norihiko Kikuchi, Emiko Hara, Tomomi Shiga, Chinami Horiuchi, Toshiyuki Sado, Yuko Matsubara, Keiichiroh Akabane, Aya Harada, Hiromi Nagase, Kazuhisa Maeda, Hiroshi Katagiri, Jun Sasahara, Hirokazu Sugii, Shunsuke Tamaru, Miyoko Waratani, Saya Tsukahara, Shohei Shibukawa, Tomoiki Kiyama, Yoshifumi Kasuga, Makiko Egawa, Hiroshi Sato, Chiyo Tamamura, Tokumasa Suemitsu, Aikou Okamoto, Osamu Samura
Institutions: Jikei University School of Medicine, Toyonaka Municipal Hospital, Uji-Tokushukai Medical Center, San-ikukai Hospital, SHOWA Medical University, National Center For Child Health and Development, Japanese Red Cross Nagoya Daini Hospital, Chigasaki Municipal Hospital, Hamamatsu Medical Center, Shiga University of Medical Science, Saga University, University of the Ryukyus University Hospital, Anjo Kosei Hospital, Kure Medical Center, Chiba University Hospital, Ehime Prefectural Central Hospital, Yokohama City University Medical Center, Hiratsuka City Hospital, Hachinohe City Hospital, Hiroshima University Hospital, Kouseiren Takaoka Hospital, Shinshu University Hospital, Kitakyushu Municipal Medical Center, Gifu University Hospital, Nara Prefecture General Medical Center, Ehime University Hospital, Ehime University, Hokkaido University Hospital, Kanagawa Children's Medical Center, Shikoku Medical Center for Children and Adults, Masuda Red Cross Hospital, Osaka Women's and Children's Hospital, Iwakuni Medical Center, Saitama Medical University Hospital, Saitama Medical University, University Hospital Kyoto Prefectural University of Medicine, Okayama Medical Center, Matsue Red Cross Hospital, Tottori Prefectural Kousei Hospital, Keio University, Keio University Hospital, Institute of Science Tokyo, Hyogo Prefectural Amagasaki General Medical Center, University of Fukui Hospital, Kameda Medical Center
Language: English
Topic: Blood groups and transfusion
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,690
OpenAlex ID: W4408723901