BACKGROUND: The objective was the evaluation of the effect of the Dutch national routine antenatal RhIG (anti-D) immunization prevention (RAADP) program comprising one single dose of 200 microg (1000 IU) of RhIG in the 30th week of pregnancy, restricted to women without a living child. STUDY DESIGN AND METHODS: A nationwide historic control study was performed. All newly detected anti-D-immunized para-1 in 1999, 2002, and 2004 were included and classified on the basis of received prophylaxis during the first pregnancy: antenatal and postnatal versus only postnatal RhIG. The numbers of D- parae-1 who delivered a D+ first child before the introduction (control group) or after the introduction (intervention group) of the RAADP were calculated from Vital Birth Statistics (8,700 and 12,000, respectively). RESULTS: Fifty-eight newly detected anti-D immunizations in the first trimester were observed in the control group and 39 in the intervention group, which resulted in a significant reduction of the prevalence of new anti-D immunizations from 0.67 percent (95% confidence interval [CI], 0.50%-0.84%) to 0.31 percent (95% CI, 0.21%-0.41%). No reduction was observed in anti-D immunizations newly detected at the 30th-week screening (0.25%). A nonsignificant risk reduction of the risk of severe hemolytic disease of the fetus and newborn (HDFN) was found (0.23% vs. 0.10%). The numbers needed to treat to prevent one anti-D-immunized pregnancy and one case of subsequent severe HDFN were 357 and 1255, respectively. CONCLUSIONS: RAADP of one single dose of 200 microg of RhIG in addition to postnatal RhIG (200 microg) halves the risk of anti-D immunization and subsequent severe HDFN.
BACKGROUND: The objective was the evaluation of the effect of the Dutch national routine antenatal RhIG (anti-D) immunization prevention (RAADP) program comprising one single dose of 200 microg (1000 IU) of RhIG in the 30th week of pregnancy, restricted to women without a living child. STUDY DESIGN AND METHODS: A nationwide historic control study was performed. All newly detected anti-D-immunized para-1 in 1999, 2002, and 2004 were included and classified on the basis of received prophylaxis during the first pregnancy: antenatal and postnatal versus only postnatal RhIG. The numbers of D- parae-1 who delivered a D+ first child before the introduction (control group) or after the introduction (intervention group) of the RAADP were calculated from Vital Birth Statistics (8,700 and 12,000, respectively). RESULTS: Fifty-eight newly detected anti-D immunizations in the first trimester were observed in the control group and 39 in the intervention group, which resulted in a significant reduction of the prevalence of new anti-D immunizations from 0.67 percent (95% confidence interval [CI], 0.50%-0.84%) to 0.31 percent (95% CI, 0.21%-0.41%). No reduction was observed in anti-D immunizations newly detected at the 30th-week screening (0.25%). A nonsignificant risk reduction of the risk of severe hemolytic disease of the fetus and newborn (HDFN) was found (0.23% vs. 0.10%). The numbers needed to treat to prevent one anti-D-immunized pregnancy and one case of subsequent severe HDFN were 357 and 1255, respectively. CONCLUSIONS: RAADP of one single dose of 200 microg of RhIG in addition to postnatal RhIG (200 microg) halves the risk of anti-D immunization and subsequent severe HDFN.
Authors: Rick Kapur; Luciana Della Valle; Myrthe Sonneveld; Agnes Hipgrave Ederveen; Remco Visser; Peter Ligthart; Masja de Haas; Manfred Wuhrer; C Ellen van der Schoot; Gestur Vidarsson Journal: Br J Haematol Date: 2014-06-07 Impact factor: 6.998
Authors: Masja de Haas; Florentine F Thurik; Catharina P B van der Ploeg; Barbera Veldhuisen; Hoang Hirschberg; Aicha Ait Soussan; Heleen Woortmeijer; Frithjofna Abbink; Godelieve C M L Page-Christiaens; Peter G Scheffer; C Ellen van der Schoot Journal: BMJ Date: 2016-11-07
Authors: C Zwiers; I T M Lindenburg; F J Klumper; M de Haas; D Oepkes; I L Van Kamp Journal: Ultrasound Obstet Gynecol Date: 2017-08 Impact factor: 7.299
Authors: Joost H J van Sambeeck; Puck D de Wit; Jessie Luken; Barbera Veldhuisen; Katja van den Hurk; Anne van Dongen; Maria M W Koopman; Marian G J van Kraaij; C Ellen van der Schoot; Henk Schonewille; Wim L A M de Kort; Mart P Janssen Journal: Front Med (Lausanne) Date: 2018-07-25
Authors: Belinda M Kumpel; Radka Saldova; Carolien A M Koeleman; Jodie L Abrahams; Agnes Hipgrave Ederveen; Kathryn L Armour; Natalia I Olovnikova; Gestur Vidarsson; Rick Kapur; Pauline M Rudd; Manfred Wuhrer Journal: Sci Rep Date: 2020-01-30 Impact factor: 4.379