Occurrence of anti-D alloantibodies among pregnant women in Kasese District, Western Uganda

• Main Authors: Mbalibulha Y, Muwanguzi E, Mugyenyi GR, Natukunda B
• Format: Article
• Language: English
• Published: Dove Medical Press 2015-04-01
• Series: Journal of Blood Medicine
• Online Access: http://www.dovepress.com/occurrence-of-anti-d-alloantibodies-among-pregnant-women-in-kasese-dis-peer-reviewed-article-JBM

Yona Mbalibulha,1 Enoch Muwanguzi,1 Godfrey R Mugyenyi,2 Bernard Natukunda1 1Department of Medical Laboratory Sciences, 2Department of Obstetrics and Gynecology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda Objectives: This study was undertaken to determine the distribution of ABO/RhD (rhesus D antigen) blood phenotypes, prevalence of anti-D alloantibodies, and the risk factors for alloimmunization among pregnant women in Kasese District, Western Uganda. Materials and methods: Ethylenediamine tetraacetic acid-containing plasma samples and serum samples were taken from pregnant women attending the antenatal clinic. The blood groups were identified using the microplate grouping method, while the presence of anti-D alloantibodies was detected by the indirect antiglobulin test (IAT). Data were also collected from the pregnant women on the risk factors associated with anti-D alloantibody formation. Results: Among the 726 participants, the blood group distribution was as follows: O: 356 (49.%); A: 190 (26.%); B: 152 (21%); and AB: 28 (4%). A total of 28 (3.86%) pregnant women were RhD negative. Anti-D alloantibodies were detected in 88 (12.1%) of the participants; and of these, 13 (14.8%) were RhD negative. Statistically significant risk factors for anti-D alloimmunization included miscarriage, stillbirth, and postpartum hemorrhage. Conclusion: Blood group O was the most common among the pregnant women in this study and the prevalence of Rh negativity was 3.8%. The frequency of anti-D alloimmunization among pregnant women in Kasese District was 12.12%, with 85.5% of these being RhD positive. Risk factors such as a history of stillbirths, miscarriages, and incidence of postpartum hemorrhage were significantly associated with anti-D alloimmunization. There is a need to routinely carry out antenatal blood grouping and IAT screening on pregnant women in Uganda to detect anti-D alloimmunization. Given the high prevalence of anti-D alloantibody formation among RhD-positive women, we recommend additional research studies on the role of autoimmunity among antigen-positive women, as well as the occurrence of RhD variants plus their implications on hemolytic disease of the fetus and newborn, in Uganda. Keywords: ABO/RhD blood groups, anti-D alloimmunization, indirect antiglobulin test, pregnant women, Western Uganda