Background: Anti-D immunoglobulins (IgG) administered to Rh-negative pregnant women cross the placenta and therefore carry a potential risk of red blood cells (RBD) hemolysis to Rh-positive fetuses. Among preterm infants born close to routine anti-D administration the higher titer of anti-D immunoglobulins may potentially have an impact on hematological parameters
Objective: To evaluate whether Rh-positive preterm newborn infants born to Rh-negative mothers treated with prophylactic anti-D immunoglobulins exhibited signs of hemolytic reaction, including anemia and hyperbilirubinemia.
Study design: Retrospective data were collected for 94 Rh-positive preterm newborns born at gestational age 28-34 weeks to76 Rh-negative mothers and for matched controls.
Results: The study and control groups were similar in all maternal and neonatal outcome parameters. We found 11.7% positive Coombs` tests among infants in the study group and slightly higher bilirubin levels at birth and on the following three days. No differences were recorded between the study and the control groups for hematocrit levels throughout hospitalization, maximal bilirubin level, phototherapy treatment or the need for blood transfusion. Using logistic regression showed that low hematocrit and the need for phototherapy were not predicted by study group preterm infants.
Conclusions: Among preterm Rh-positive newborn infants born to Rh-negative mothers there appears to be no evidence of significant hemolytic reaction derived from placental anti-D transfer. Further prospective studies are needed to confirm these findings in order to support anti-D administration close to preterm birth.
