{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:16Z","timestamp":1789609096375,"version":"build-2803163510"},"reference-count":30,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"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":[[2020,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Alloimmunization can impact both the fetus and neonate. Study objectives: (a) calculate the incidence of clinically significant RBC isoimmunization during pregnancy, (b) review maternal management and neonatal outcomes, (c) assess the value of prenatal and postnatal serological testing in predicting neonatal outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design and Methods<\/jats:title><jats:p>A retrospective audit of consecutive alloimmunized pregnancies was conducted. Data collected included demographics, clinical outcomes, and laboratory results. Outcomes included: incidence of alloimmunization; outcomes for neonates with and without the cognate antigen; and sensitivity and specificity of antibody titration testing in predicting hemolytic disease of the fetus and newborn (HDFN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Over 6\u2009years, 128 pregnant women (0.4%) were alloimmunized with 162 alloantibodies; anti\u2010E was the most common alloantibody (51\/162; 31%). Intrauterine transfusions (IUTs) were employed in 2 (3%) of 71 mothers of cognate antigen positive (CoAg+) neonates. Of 74 CoAg+ neonates, 58% required observation alone, 23% intensive phototherapy, 9% top up transfusion, and 3% exchange transfusion; no fetal or neonatal deaths occurred. HDFN was diagnosed in 28% (21\/74) of neonates; anti\u2010D was the most common cause. The sensitivity and specificity of the critical gel titer &gt;32 in predicting HDFN were 76% and 75%, respectively (negative predictive value 95%; positive predictive value 36%). The sensitivity and specificity of a positive direct antiglobulin test (DAT) in predicting HDFN were 90% and 58%, respectively (NPV 97%; PPV 29%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Morbidity and mortality related to HDFN was low; most alloimmunized pregnancies needed minimal intervention. Titers of &gt;32 by gel warrant additional monitoring during pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.16061","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T06:51:29Z","timestamp":1605941489000},"page":"2537-2546","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Impact of red blood cell alloimmunization on fetal and neonatal outcomes: A single center cohort study"],"prefix":"10.1111","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3633-0728","authenticated-orcid":false,"given":"Lani","family":"Lieberman","sequence":"first","affiliation":[{"name":"Department of Clinical Pathology University Health Network  Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine &amp; Pathobiology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre  Toronto Ontario Canada"},{"name":"Education and Safety in Transfusion (QUEST) Research Program University of Toronto Quality in Utilization  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6133-0677","authenticated-orcid":false,"given":"Jeannie","family":"Callum","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine &amp; Pathobiology University of Toronto  Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre  Toronto Ontario Canada"},{"name":"Education and Safety in Transfusion (QUEST) Research Program University of Toronto Quality in Utilization  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Molecular Diagnostics Sunnybrook Health Sciences Centre  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5297-6406","authenticated-orcid":false,"given":"Christine","family":"Cserti\u2010Gazdewich","sequence":"additional","affiliation":[{"name":"Department of Clinical Pathology University Health Network  Toronto Ontario Canada"},{"name":"Department of Laboratory Medicine &amp; Pathobiology University of Toronto  Toronto Ontario Canada"},{"name":"Education and Safety in Transfusion (QUEST) Research Program University of Toronto Quality in Utilization  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noor Niyar N.","family":"Ladhani","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine &amp; 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