{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:49:06Z","timestamp":1790419746989,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,2,27]],"date-time":"2022-02-27T00:00:00Z","timestamp":1645920000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012446","name":"Akershus Universitetssykehus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012446","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>In September 2016, a nationwide targeted routine antenatal anti\u2010D prophylaxis program was implemented in Norway. The prophylaxis (anti\u2010D immunoglobulin) aims to cover the whole third trimester and is administered in gestational week 28 to RhD\u2010negative women who carry <jats:italic>RhD<\/jats:italic>\u2010positive fetuses. However, in many women, antibody screening at delivery does not detect anti\u2010D immunoglobulin. The goal of this study was to investigate the presumable role of dose and timing of antenatal anti\u2010D immunoglobulin administration in non\u2010detectable prophylaxis at the time of delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>In this retrospective observational study, RhD\u2010negative pregnant women who gave birth at Oslo University Hospital and Akershus University Hospital between January 2017 and December 2019 were analyzed. Women who received antenatal anti\u2010D immunoglobulin (1500\u00a0IU at Oslo University Hospital and 1250\u00a0IU at Akershus University Hospital) when fetal <jats:italic>RHD<\/jats:italic> genotyping at gestational week 24 predicted an RhD\u2010positive fetus were included if an antibody screen at delivery was available. Data from the blood bank, maternity information systems, and electronic patient records were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Analysis of the 984 RhD\u2010negative women at the two hospitals revealed that 45.4% had non\u2010detectable anti\u2010D at delivery. A significant difference between the two hospitals was observed: 40.5% at Oslo University Hospital (<jats:italic>n<\/jats:italic>\u00a0=\u00a0509) and 50.7% at Akershus University Hospital (<jats:italic>n<\/jats:italic>\u00a0=\u00a0475) (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.001). The proportion with non\u2010detectable anti\u2010D increased to 56.0 and 75.3%, respectively (<jats:italic>p<\/jats:italic>\u00a0=\u00a00.008) in the group of women who gave birth 12 weeks after routine antenatal anti\u2010D prophylaxis. Significantly fewer women had detectable anti\u2010D at delivery when the lower anti\u2010D immunoglobulin dose (1250\u00a0IU) was administered antenatally. Multiple logistic regression indicated that the time interval between routine antenatal anti\u2010D prophylaxis and delivery, in addition to anti\u2010D dose, were significantly associated with detectable anti\u2010D at delivery (<jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We do not know which RhD\u2010negative pregnant women, despite antenatal anti\u2010D prophylaxis, are at risk of RhD alloimmunization, when antibody screening is negative at delivery. Administration of antenatal prophylaxis should probably be moved closer to delivery, since the risk of fetomaternal hemorrhage is higher during the last weeks of the third trimester.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14328","type":"journal-article","created":{"date-parts":[[2022,2,28]],"date-time":"2022-02-28T04:14:02Z","timestamp":1646021642000},"page":"431-440","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Following targeted routine antenatal <scp>anti\u2010D<\/scp> prophylaxis, almost half of the pregnant women had undetectable <scp>anti\u2010D<\/scp> prophylaxis at delivery"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3508-4764","authenticated-orcid":false,"given":"Kirsten","family":"S\u00f8rensen","sequence":"first","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1543-9994","authenticated-orcid":false,"given":"Helena Eriksson","family":"Stjern","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bente Anita Grande","family":"Karlsen","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geir","family":"Tomter","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Ystad","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida","family":"Herud","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette Silihagen","family":"B\u00e6vre","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abid Hussain","family":"Llohn","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Akershus University Hospital  L\u00f8renskog Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7615-2906","authenticated-orcid":false,"given":"\u00c7i\u011fdem Akal\u0131n","family":"Akk\u00f6k","sequence":"additional","affiliation":[{"name":"Department of Immunology and Transfusion Medicine Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/tme.12772"},{"key":"e_1_2_11_3_1","unstructured":"Norwegian Society of Gynecology and Obstetrics (Norsk gynekologisk forening).Veileder i f\u00f8dselshjelp \u2010 Alloimmunisering mot erytrocytt\u2010antigener (The Norwegian national guidelines for obstetrics \u2010RBC alloimmunization) 2020 [cited 2021 09.06.]. Available from:https:\/\/www.legeforeningen.no\/foreningsledd\/fagmed\/norsk\u2010gynekologisk\u2010forening\/veiledere\/veileder\u2010i\u2010fodselshjelp\u20102020\/alloimmunisering\u2010mot\u2010erytrocytt\u2010antigener\/."},{"key":"e_1_2_11_4_1","unstructured":"Arentz\u2010HansenH BrurbergKG KvammeMK et al.NIPH systematic reviews. Determination of fetal rhesus D status from maternal plasma of rhesus negative women. 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