Rh(D)阴性孕妇产前免疫抗体状态与新生儿溶血病相关性分析

Correlation analysis between immune state of Rh(D)-negative pregnant women and hemolytic disease of newborn

目的探讨Rh(D)阴性孕妇产前免疫抗体状态与新生儿溶血病(HDN)的相关性。方法回顾性分析本院2000—2004年43例Rh(D)阴性孕妇的妊娠、分娩情况,及其IgG抗D效价。结果31例产下正常新生儿,其中26例初产妇和3例孕2次者未检出抗Rh(D)IgG,另有人流后和第2胎各1例注射抗Rh(D)IgG抗体后维持效价低于8。其余12例效价均超过32,其中初产妇有输血史1例,孕2次者5例,孕3次以上者6例,2例孕中期(32,34周)胎死宫内,10例(23%)发生HDN。结论Rh(D)阴性孕妇抗D抗体的产生及其效价有明显个体差异,但孕3次以上者效价普遍超过32,高抗D效价往往导致HDN。

Objective It is to discuss the correlation between immune state of Rh（D）-negative pregnant women and hemolytic disease of newborn （HDN）. Methods The clinical data of 43 Rh（D）-negative pregnant women during 2000 to 2004 were analyzed retrospectively, including gestation, delivery and their immune state. Results There were 31 cases of normal newborn including 26 cases primipara, three women at second gestation with no detection of anti-D IgG and two women at second gestation having received antibodies against the anti-D IgG to maintain the titer less than 8. The titer of other 12 cases was more than 32, including a primipara with transfusion, five women with second gestation, and six women with more than three times gestation. Two cases of pregnancy were broken off at 32 and 34 weeks, and 10 cases of HDN occurred （23 % ）. Conclusion The production and titer of anti-D IgG in Rh（D）-negative pregnant women indicate significant individual difference. Whereas, commonly the women with more than three times gestation have titer more than 32, which tends to cause HDN.