Rh血型的D抗原由于其在胎儿和新生儿中引起溶血性输血反应和溶血性疾病的能力而被认为具有临床意义。本系统综述讨论了RhD变异在孕妇中的患病率,以及将RhD基因分型用于产前检查以检测RhD变异并预防抗D同种免疫的重要性。使用科学搜索引擎进行了全面的文献检索,包括PubMed和MEDLINE数据库,关键字为“抗D同种免疫”,\'RhD变体\',和\'孕妇。审查遵循PRISMA指南。使用MedCalc版本20进行Meta分析。对于所有双尾检验,p≤0.05的显着性水平被认为具有统计学意义。荟萃分析包括四篇符合纳入标准的文章。RhD阳性(RhD+)的总患病率为61%(95%CI:34%-85%)。患病率从22%到82%不等,表明研究之间的高度异质性(I2=98.71%,p<0.0001)。D变异的总体患病率为15%(95%CI,9%-23%),患病率为0.05%至100%,研究之间表现出高度的异质性(I2=99.89%,p<0.0001)。抗D同种免疫可能发生在具有某些类型的RhD变体的孕妇中。所有四项研究都集中在使用血清学方法对至少两种抗D抗体的样品进行分子测试,这些样品显示出不一致或弱的结果。
The D antigen of the Rh blood group is considered clinically significant due to its ability to cause hemolytic transfusion reactions and hemolytic disease in the fetus and newborn. This systematic
review discusses the prevalence of RhD variants among pregnant women and the importance of including RhD genotyping for prenatal testing to detect RhD variants and prevent anti-D alloimmunization. A comprehensive literature search was conducted using scientific search engines, including PubMed and MEDLINE databases, with the keywords \'anti-D alloimmunization\', \'RhD variant\', and \'pregnant women.\' The
review adhered to the PRISMA guidelines. Meta-analysis was performed using MedCalc version 20. A significance level of p≤0.05 was considered statistically significant for all two-tailed tests. The meta-analysis included four articles that met the inclusion criteria. The total prevalence of RhD positivity (RhD+) was 61% (95% CI:34%-85%). The prevalence ranged from 22% to 82%, indicating a high degree of heterogeneity between studies (I2=98.71%, p<0.0001). The overall prevalence of D variants was 15% (95% CI, 9%-23%) with a prevalence of 0.05% to 100%, showing a high degree of heterogeneity between studies (I2=99.89%, p<0.0001). Anti-D alloimmunization could occur in pregnant women with some types of RhD variants. All four studies focused on molecular testing of samples showing inconsistent or weak results with at least two anti-D antibodies using serological methods.