{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:48:13Z","timestamp":1790419693900,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T00:00:00Z","timestamp":1577059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Pregnant women are routinely screened for red blood cell (RBC) antibodies early in pregnancy. If RBC\u2010alloantibodies are detected, repeated laboratory testing is advised to timely identify pregnancies at high risk for severe hemolytic disease of the fetus and newborn (HDFN). We assessed for RBC alloantibodies, other than anti\u2010D or anti\u2010K, cut\u2010offs for the titer and the antibody dependent cellular cytotoxicity (ADCC) test to select high\u2010risk cases. To advise on test repeat intervals, and to avoid unnecessary testing, we evaluated the chance for exceeding the cut\u2010offs for Rh antibodies other than anti\u2010D, Jk, Fy, and S\/s antibodies.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN AND METHODS<\/jats:title><jats:p>Diagnostic value of antibody titer and ADCC test was determined with data from a prospective index\u2010cohort study, conducted in 2002\u20102004. Laboratory test outcomes were from a recent observational cohort (2015\u20102016).<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>A titer cut\u2010off of \u226516 showed a sensitivity of 100% (95% CI:73\u2010100%) and a positive predictive value (PPV) of 17% (95% CI:14%\u201020%). The percentage of pregnancies reaching a titer above the cut\u2010off of \u226516 varied from 0% for anti\u2010Jk<jats:sup>a<\/jats:sup>\/Jk<jats:sup>b<\/jats:sup> (n = 38) to 36% for anti\u2010c (n = 97). The ADCC test showed no cut\u2010off with a 100% sensitivity. However, in cases with a titer \u226516 and an ADCC test \u226530% a PPV of 38% was obtained to detect severe HDFN.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>A titer cut\u2010off of \u226516 is adequate to detect all cases at risk for severe HDFN; the ADCC test may add a more accurate risk estimation. Repeated testing is recommended in pregnancies with anti\u2010c. In pregnancies with other Rh antibodies a repeated test in the third trimester is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15631","type":"journal-article","created":{"date-parts":[[2019,12,23]],"date-time":"2019-12-23T09:12:37Z","timestamp":1577092357000},"page":"391-399","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Diagnostic value of laboratory monitoring to predict severe hemolytic disease of the fetus and newborn in non\u2010D and non\u2010K\u2010alloimmunized pregnancies"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0532-0022","authenticated-orcid":false,"given":"Johanna Maria","family":"Koelewijn","sequence":"first","affiliation":[{"name":"Department of Experimental Immunohematology Sanquin Research and Landsteiner Laboratory  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolentha Maria","family":"Slootweg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"},{"name":"Center of Clinical Transfusion Research Sanquin Research and Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Folman","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Services Sanquin  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inge Louise","family":"van Kamp","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dick","family":"Oepkes","sequence":"additional","affiliation":[{"name":"Department of Obstetrics Leiden University Medical Center  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masja","family":"de Haas","sequence":"additional","affiliation":[{"name":"Center of Clinical Transfusion Research Sanquin Research and Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Immunohematology and Blood Transfusion Leiden University Medical Center  Leiden The Netherlands"},{"name":"Department of Diagnostic Services Sanquin  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,12,23]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"21","article-title":"Antenatal care for uncomplicated pregnancies","volume":"62","author":"National Institute for Health and Care Excellence (NICE)","year":"2008","journal-title":"Clinical Guideline"},{"key":"e_1_2_8_3_1","first-page":"e82\u2010e90","article-title":"ACOG Practice Bulletin No. 192: management of alloimmunization during pregnancy","volume":"131","author":"American College of Obstetricians and Gynecologists (ACOG)","year":"2018","journal-title":"Obstet Gynecol"},{"key":"e_1_2_8_4_1","volume-title":"Red cell immunization and pregnancy Guideline NVOG, version 2.1.","author":"Dutch Society of Obstetrics and Gynaecology (NVOG)","year":"2009"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/vox.12265"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa052855"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2007.01625.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.siny.2008.02.007"},{"key":"e_1_2_8_9_1","first-page":"496","volume-title":"Blood Transfusion in Clinical Medicine","author":"Mollison PL","year":"2005"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2001.112970"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2005.04.007"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2018.07.020"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000109206.22354.2C"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000149153.93417.66"},{"key":"e_1_2_8_15_1","first-page":"355","article-title":"Sensitivity of fetal RHD screening for safe guidance of targeted anti\u2010D immunoglobulin prophylaxis: prospective cohort study of a nationwide programme in the Netherlands","volume":"5789","author":"Haas M","year":"2016","journal-title":"BMJ"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0950-3536(05)80053-8"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2010.01307.x"},{"key":"e_1_2_8_18_1","volume-title":"Prenatale Screening Infectieziekten en Erytrocytenimmunisatie. 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