Male fetuses are particularly affected by maternal alloimmunization to D antigen

Transfusion. 1999 Feb;39(2):169-73. doi: 10.1046/j.1537-2995.1999.39299154731.x.

Abstract

Background: It is hypothesized that male fetuses are more severely affected by fetomaternal alloimmunization to D antigen than female fetuses.

Study design and methods: One hundred four consecutive pregnancies with single D+ fetuses (51 males, 53 females) and maternal anti-D titers >16 were analyzed retrospectively.

Result: Sixty fetuses (58%) received intrauterine transfusions. Male fetuses required more transfusions than females (5.0 vs. 2.0, p = 0.0001). At the initial transfusion, male fetuses had a lower gestational age (24.5 vs. 31.0 weeks, p = 0.0007), cord blood hemoglobin content (6.45 vs. 8.75 g/dL, p = 0.01), and hematocrit (19.8 vs. 26.8%, p = 0.004) than female fetuses. After adjustment for maternal gravidity, parity, and history of affected offspring, the odds ratio for development of hydrops by male fetuses was 13.1 (95% CI 2.69-63.6, p = 0.001). Perinatal mortality was higher in male (18%) fetuses than in female (6%) (adjusted odds ratio for males 3.38; 95% CI 0.59-19.46, p = 0.17).

Conclusion: Male fetuses are particularly affected by maternal alloimmunization to D and require more intense antepartum surveillance than female fetuses.

MeSH terms

  • Adult
  • Anemia, Neonatal / immunology
  • Female
  • Fetal Death
  • Humans
  • Hydrops Fetalis / immunology
  • Infant Mortality
  • Infant, Newborn
  • Linear Models
  • Male
  • Maternal-Fetal Exchange / immunology*
  • Peptides / blood*
  • Pregnancy
  • Retrospective Studies
  • Rh Isoimmunization*
  • Rh-Hr Blood-Group System / blood*
  • Sex Characteristics*

Substances

  • Peptides
  • Rh-Hr Blood-Group System
  • Rho(D) antigen