We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Does Rh immune globulin suppress HLA sensitization in pregnancy?
- Authors
Kaufman, Richard M.; Schlumpf, Karen S.; Wright, David J.; Triulzi, Darrell J.
- Abstract
Background How Rh immune globulin ( RhIG) prevents sensitization to D antigen is unclear. If RhIG Fc delivers a nonspecific immunosuppressive signal, then RhIG may inhibit sensitization to antigens other than D. HLA antibody prevalence was compared in previously pregnant D- versus D+ women to investigate whether RhIG suppresses HLA sensitization. Study Design and Methods In the Leukocyte Antibody Prevalence Study ( LAPS), 7920 volunteer blood donors were screened for anti- HLA and surveyed about prior pregnancies and transfusions. A secondary analysis of the LAPS database was performed. Results D- women not more than 40 years old (presumed to have received antenatal with or without postpartum RhIG in all pregnancies) had a significantly lower HLA sensitization rate than D+ women (relative risk, 0.58; 95% confidence interval [ CI], 0.40-0.83). When stratified by deliveries (one, two, three, or four or more), D- women not older than 40 were HLA sensitized less often than D+ women in every case. In contrast, a clear relationship between D type and HLA sensitization was not seen in older previously pregnant women whose childbearing years are presumed to have preceded the use of routine RhIG prophylaxis. In a multivariable logistic regression model, D- women not more than 40 years old remained significantly less likely to be HLA sensitized compared with D+ women after adjusting for parity, time from last pregnancy, lost pregnancies, and transfusions (odds ratio [ OR], 0.55; 95% CI, 0.34-0.88). Conclusion Consistent with a nonspecific immunosuppressive effect of RhIG, younger previously pregnant D- women were less likely than previously pregnant D+ women to be HLA sensitized.
- Subjects
PREGNANCY; RHO(D) immune globulin; IMMUNOSUPPRESSIVE agents; TRANSFER factor (Immunology); BLOOD donors; LEUCOCYTES
- Publication
Transfusion, 2013, Vol 53, Issue 9, p2069
- ISSN
0041-1132
- Publication type
Article
- DOI
10.1111/trf.12049