The continuing burden of Rh disease 50 years after the introduction of anti-Rh(D) immunoglobin prophylaxis: call to action

Am J Obstet Gynecol. 2019 Sep;221(3):227.e1-227.e4. doi: 10.1016/j.ajog.2019.05.019. Epub 2019 May 20.


Severe morbidity and death because of Rh disease have only been reduced by approximately 50% globally during the last 50 years, despite the advent of anti-Rh(D) immunoglobin prophylaxis, which has resulted in >160,000 perinatal deaths and 100,000 disabilities annually. This apparent failure to take appropriate preventive measures is of great concern. Thus, there is a great need to do much better. We wish to draw attention to the unnecessary continuing burden of Rh disease, to discuss some of the reasons for this failure, and to provide suggestions for a better way forward.

Keywords: Rh disease; alloimmunization; blood groups; fetal anemia; hemolysis; hemolytic disease of the fetus and newborn; hyperbilirubinemia; isoimmunization; prevention.

MeSH terms

  • Female
  • Health Services Accessibility
  • Humans
  • Immunologic Factors / supply & distribution*
  • Immunologic Factors / therapeutic use*
  • Internationality
  • Pregnancy
  • Prenatal Care
  • Rh Isoimmunization / prevention & control*
  • Rh-Hr Blood-Group System / immunology
  • Rho(D) Immune Globulin / therapeutic use*


  • Immunologic Factors
  • Rh-Hr Blood-Group System
  • Rho(D) Immune Globulin