目的:分析孕妇产前红细胞血型意外抗体检出率及分布特征,探讨孕产史与意外抗体及不同特异性抗体的相关性,分析意外抗体与新生儿溶血病(hemolytic disease of newborn,HDN)的关系.方法:收集2018-2023年在宁波大学附属妇女儿童医院生产备血且无输血史的孕妇意外抗体筛查及鉴定资料,分析抗体检出率及其分布特征;收集孕妇孕次以及产次等信息,分析孕产史与意外抗体检出的相关性.收集产妇及新生儿的临床资料,分析意外抗体与非ABO新生儿溶血病(ABO-HDN)的关系.结果:在63 142例无输血史的孕妇中,共检出274例意外抗体,检出率为0.43％,以Rh、MNS和Lewis血型系统抗体为主.其中Rh血型系统的意外抗体占比高达41.97％,主要为抗-E;其次为MNS血型系统抗体,占比28.83％,以抗-M为主;Lewis血型系统抗体占17.15％,以抗-Lea为主.经产妇意外抗体检出率明显高于初产妇(0.61％vs 0.31％,P＜0.01).孕次在2次以上的孕妇意外抗体检出率明显高于孕次为1～2次的孕妇(0.59％vs 0.35％,P＜0.01);在不同特异性的意外抗体中,Rh血型系统意外抗体检出率在经产妇中明显高于初产妇(0.35％vs 0.06％,P＜0.01),而MNS血型系统和Lewis血型系统意外抗体检出率在初产妇组和经产妇组中的差异无统计学意义(MNS血型系统:0.13％vs 0.12％,Lewis血型系统:0.08％vs 0.07％,P＞0.05).Rh血型系统中的抗-D是引起非ABO-HDN的主要抗体.结论:孕产史与孕妇产前意外抗体检出有关,主要影响Rh血型系统抗体,与MNS血型系统和Lewis血型系统无相关性.孕妇产前意外抗体检测有利于早期确定有临床意义的抗体,对于早期诊断和治疗HDN具有重要意义.
Analysis of prenatal unexpected antibodies screening and identification results of pregnant women
Objective:To analyze the detection rate and distribution characteristics of unexpected antibodies to erythrocyte blood group in pregnant women,to explore the correlation between the history of pregnancy and the overall and different specific antibodies of unexpected antibodies,and to analyze the relationship between unexpect-ed antibodies and hemolytic disease of newborn.Methods:The data of unexpected antibodies screening and identi-fication of pregnant women who had blood preparation and no history of blood transfusion in Women and Children's Hospital of Ningbo University from 2018 to 2023 were collected,and the antibody detection rate and distribution characteristics were analyzed.The data of gravidity and parity of pregnant women were collected,and the correlation between pregnancy history and unexpected antibody detection was analyzed.The clinical data of mothers and newborns were collected,and the relationship between unexpected antibodies and non-ABO-HDN was analyzed.Results:Among 63 142 pregnant women with no history of blood transfusion,274 unexpected anti-bodies were detected,with a detection rate of 0.43％.The proportion of unexpected antibodies in Rh blood group system was as high as 41.97％,mainly anti-E.Followed by MNS blood group system antibody,accounting for 28.83％,mainly anti-M;The Lewis blood group system antibody(17.15％)was mainly anti-Lea.In general,the unexpected antibody detection rate of multiparas was significantly higher than that of primiparas(0.61％vs 0.31％,P＜0.01).The rate of unexpected antibody in pregnant women with more than 2 pregnancies was signif-icantly higher than that in pregnant women with 1-2 pregnancies(0.59％vs 0.35％,P＜0.01).Among the unex-pected antibodies of different specificities,the detection rate of unexpected antibodies against Rh blood group sys-tem in multiparas was significantly higher than that in primiparas(0.35％vs 0.06％,P＜0.01).However,there was no significant difference in the unexpected antibody detection rate of MNS and Lewis blood group system be-tween primipara and multipara groups(MNS blood group system:0.13％vs 0.12％,Lewis blood group system:0.08％vs 0.07％,P＞0.05).Anti-D antibody in Rh blood group system is the main antibody causing non-ABO-HDN.Conclusion:The history of pregnancy and childbirth is related to the unexpected antibodies detection of pregnant women,which mainly affects the Rh blood group system antibodies,and has no correlation with MNS blood group system and Lewis blood group system.Unexpected prenatal antibody detection in pregnant women is conducive to early identification of clinically significant antibodies,which is of great significance for early diagnosis and treatment of hemolytic disease of the newborn.
unexpected antibodiespregnant womenhemolytic disease of the newborn
NETL
NSTL
万方数据
