Male fetuses are particularly affected by maternal alloimmunization to D antigen
Article first published online: 19 DEC 2002
Volume 39, Issue 2, pages 169–173, February 1999
How to Cite
Ulm, B., Svolba, G., Ulm, M. R., Bernaschek, G. and Panzer, S. (1999), Male fetuses are particularly affected by maternal alloimmunization to D antigen. Transfusion, 39: 169–173. doi: 10.1046/j.1537-2995.1999.39299154731.x
- Issue published online: 19 DEC 2002
- Article first published online: 19 DEC 2002
- Received for publication February 20, 1998; revision received and accepted June 19, 1998.
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% Cl 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% Cl 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.