{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:24:02Z","timestamp":1789025042282,"version":"build-2803163510"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T00:00:00Z","timestamp":1449792000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2016,5]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effect of red blood cell (<jats:styled-content style=\"fixed-case\">RBC<\/jats:styled-content>) antibody screening in the 27th week of pregnancy in Rhc\u2010negative women, on detection of alloimmunisation, undetected at first trimester screening (\u2018late\u2019 alloimmunisation), and subsequent haemolytic disease of the fetus and newborn (<jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content>), to assess risk factors for late alloimmunisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Prospective cohort and nested case\u2013control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The Netherlands.<\/jats:p><\/jats:sec><jats:sec><jats:title>Population<\/jats:title><jats:p>Two\u2010year nationwide cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Prospective inclusion of Rhc\u2010negative women with negative first trimester screening and of screen\u2010negative controls. Assessment of incidence and numbers needed to screen (<jats:styled-content style=\"fixed-case\">NNS<\/jats:styled-content>) of late alloimmunisation and <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content>; logistic regression analysis to establish risk factors for late alloimmunisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Late alloimmunisation, <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Late alloimmunisation occurred in 99 of 62 096 (0.159%) Rhc\u2010negative women; 90% had c\/E antibodies and 10% non\u2010Rhesus antibodies. Severe <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content> (fetal\/neonatal transfusion) occurred in two of 62 096 (0.003%) of Rhc\u2010negative women and 2% of late alloimmunisations; moderate <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content> (phototherapy) occurred in 20 children [22.5%; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 13.8\u201331.1%]. Perinatal survival was 100%. The <jats:styled-content style=\"fixed-case\">NNS<\/jats:styled-content> to detect one <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content> case was 2823 (31 048 for severe, 3105 for moderate <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content>). Significant risk factors were former blood transfusion [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>), 10.4; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.14\u201394.9], parity (<jats:italic>P<\/jats:italic>\u22121: <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 11.8; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 3.00\u201346.5; <jats:italic>P<\/jats:italic> &gt; 1: <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 7.77; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.70\u201335.4) and amniocentesis\/chorionic villus sampling during current pregnancy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>, 9.20; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.16\u201372.9).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Additional screening of Rhc\u2010negative women improved the detection of late alloimmunisation and <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content>, facilitating timely treatment, with a <jats:styled-content style=\"fixed-case\">NNS<\/jats:styled-content> of 2823. Independent risk factors for late alloimmunisation were blood transfusion, parity and chorionic villus sampling\/amniocentesis in the current pregnancy. The occurrence of most factors before the current pregnancy suggests a secondary immune response explaining most late alloimmunisations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Tweetable abstract<\/jats:title><jats:p>Third trimester screening for alloimmunisation in Rhc\u2010neg women improves detection and treatment of severe <jats:styled-content style=\"fixed-case\">HDFN<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.13816","type":"journal-article","created":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T11:36:58Z","timestamp":1449833818000},"page":"955-963","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Third trimester screening for alloimmunisation in <scp>R<\/scp>hc\u2010negative pregnant women: evaluation of the <scp>D<\/scp>utch national screening programme"],"prefix":"10.1111","volume":"123","author":[{"given":"YM","family":"Slootweg","sequence":"first","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JM","family":"Koelewijn","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Academic Medical Centre University of Amsterdam Amsterdam the Netherlands"},{"name":"Department of Experimental Immunohaematology Sanquin Research Amsterdam the Netherlands"},{"name":"Department of General Practice University Medical Centre Groningen the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"IL","family":"van Kamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JG","family":"van der Bom","sequence":"additional","affiliation":[{"name":"Centre for Clinical Transfusion Research, Sanquin Research Department of Clinical Epidemiology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"de Haas","sequence":"additional","affiliation":[{"name":"Department of Experimental Immunohaematology Sanquin Research Amsterdam the Netherlands"},{"name":"Leiden University Medical Centre Department of Translational Immunohematology Leiden the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,12,11]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"25","volume-title":"Alloimmune Disorders of Pregnancy. 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