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- Title
Prevalence of positive direct antiglobulin test and clinical outcomes in Surinamese newborns from D-negative women.
- Authors
Zonneveld, Rens; Lamers, Margriet; Schonewille, Henk; Brand, Anneke; Kanhai, Humphrey H.H.; Zijlmans, Wilco C.W.R.
- Abstract
<bold>Background: </bold>In low-resource countries, screening for D antibodies to detect pregnancies at risk for hemolytic disease of the newborn is not routine practice. Retrospective data showed that 5.5% of Surinamese newborns of D-negative women had a positive direct antiglobulin test (DAT), indicating the presence of maternal antibodies against fetal antigens. Here, the frequency and clinical relevance of DAT positivity is evaluated.<bold>Study Design and Methods: </bold>Between April 2015 and June 2016, an observational, multicenter cohort study was undertaken among Surinamese newborns born to D-negative women. In newborns, the DAT was performed, and clinical outcomes between DAT-negative and DAT-positive newborns were compared.<bold>Results: </bold>Of the 232 evaluable newborns, 19 (8.2%) had a positive DAT, of which 11 of 15 antibody-tested newborns had D antibodies. DAT-positive newborns had lower hemoglobin levels (p = 0.02) and a trend toward higher bilirubin concentrations (p = 0.09) in the first days of life compared with DAT-negative newborns. DAT-positive newborns were admitted more frequently (p = 0.02), needed phototherapy treatment almost four times as often as DAT-negative newborns (26% vs. 7%; p = 0.008), and therapy took 2 days longer (p = 0.01). Exchange transfusions were performed in two newborns with D antibodies, both complicated with sepsis. The hospital stay was 2.5 days longer for DAT-positive newborns (p = 0.007). Overall, the prevalence of hemolytic disease of the newborn requiring treatment was 2.2% among the whole cohort of newborns.<bold>Conclusion: </bold>We found a high prevalence of DAT positivity with substantial need for hyperbilirubinemia treatment in newborns in Suriname. These results stress the necessity for better management procedures in D-negative women.
- Subjects
SURINAME; COOMBS' test; NEWBORN infants; SURINAMESE; ANTIGENS; IMMUNOGLOBULINS; ERYTHROBLASTOSIS fetalis; HYPERBILIRUBINEMIA; RH factor; RHO(D) immune globulin; TREATMENT effectiveness; DISEASE prevalence; RETROSPECTIVE studies
- Publication
Transfusion, 2017, Vol 57, Issue 10, p2496
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.14229