背景:根据现有文献尚不清楚妊娠未鉴定特异性(SRUS)的血清学反应性的临床意义。这项研究的目的是确定SRUS是否与胎儿和新生儿的溶血病(HDFN)有关。
方法:在11年的研究期间(2010-2020年),从8个机构收集了回顾性数据。如果可用(5/8网站)。SRUS-no怀孕的结果,温和,中度,或重度HDFN-确定。
结果:在589例妊娠中发现了SRUS。在排除那些数据不完整的人之后,共有284例妊娠纳入了主要HDFN结局分析.在孤立的124例(44%)怀孕中检测到SRUS,没有人受到HDFN的影响。在41例SRUS和ABO不相容的怀孕中,37(90%)未受影响,和4(10%)与轻度HDFN相关。在98例具有SRUS和并发可识别的抗体反应性的妊娠中,80(81%)未受影响,19例(19%)与轻度至重度HDFN相关。在21例SRUS妊娠中,有1例轻度HDFN和1例重度HDFN,ABO不兼容,和同时可识别的抗体反应性,19人(90%)未受HDFN影响。在所有重复测试的患者中,新发现的同种抗体或其他抗体在212例患者中的63例(30%)中被发现.虽然大多数没有临床意义,有时SRUS先于与HDFN相关的临床显著抗体(3%,5/188)。
结论:单独的SRUS的产前血清学发现与HDFN无关,但可能先于具有临床意义的抗体。
The clinical significance of serologic reactivity of unidentified specificity (SRUS) in pregnancy is not clear based on available literature. The aim of this study is to determine if SRUS is associated with hemolytic disease of the fetus and newborn (
HDFN).
Retrospective data were collected from eight institutions over an 11-year study period (2010-2020), when available (5/8 sites). The outcome of the pregnancies with SRUS-no, mild, moderate, or severe
HDFN-was determined.
SRUS was demonstrated in 589 pregnancies. After excluding those with incomplete data, a total of 284 pregnancies were included in the primary HDFN outcome analysis. SRUS was detected in 124 (44%) pregnancies in isolation, and none were affected by
HDFN. Of 41 pregnancies with SRUS and ABO incompatibility, 37 (90%) were unaffected, and 4 (10%) were associated with mild HDFN. Of 98 pregnancies with SRUS and concurrent identifiable antibody reactivity(s), 80 (81%) were unaffected, and 19 (19%) were associated with mild to severe HDFN. There was 1 case of mild
HDFN and 1 case of severe
HDFN in the 21 pregnancies with SRUS, ABO incompatibility, and concurrent identifiable antibody reactivity(s), and 19 (90%) were unaffected by
HDFN. Among all patients with repeat testing, newly identified alloantibodies or other antibodies were identified in 63 of 212 (30%) patients. Although most were not clinically significant, on occasion SRUS preceded clinically significant antibody(s) associated with HDFN (3%, 5/188).
The antenatal serologic finding of SRUS in isolation is not associated with HDFN but may precede clinically significant antibodies.