{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:01:02Z","timestamp":1787238062892,"version":"build-2736575974"},"reference-count":64,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T00:00:00Z","timestamp":1741564800000},"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":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rho(D) immune globulin (RhIg) is used to reduce RhD alloimmunization in pregnancy. This study describes potential causes for RhD alloimmunization after the development and implementation of RhIg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>This retrospective descriptive study investigated RhD\u2010negative patients born in 1965\u20132005 with anti\u2010D newly identified during 2018\u20132022. Transfusion, pregnancy, intravenous drug abuse, and transplantation were considered potential alloimmunization sources.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 1200 study patients (852 females; 348 males) at 30 institutions in 5 countries (USA, Canada, UK, New Zealand, Brazil). Most patients had a single potential source of alloimmunization identified (857\/1200, 71%), most commonly pregnancy among females (537\/852, 63%) and transfusion among males (180\/348, 52%). When multiple potential sources were included, males were more likely than females to have a history of transfusion (235\/348 [68%] vs. 149\/852 [17%],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001) and confirmed or suspected intravenous drug abuse (100\/348 [29%] vs. 138\/852 [16%],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001). Among females with a history of pregnancy, 119\/718 (17%) had healthcare access issues, 120\/718 (17%) had pregnancy in a country where they may not have received RhIg, and 21\/718 (3%) refused RhIg. Among patients with a history of transfusion, males were more likely than females to have received RhD\u2010positive red blood cells or whole blood (143\/235 [61%] vs. 30\/149 [20%],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001) and\/or platelets (84\/235 [36%] vs. 19\/149 [13%],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Pregnancy was the most frequently identified potential source of RhD alloimmunization among females. Transfusion was most frequent in males. Intravenous drug abuse as a common potential source among patients with RhD alloimmunization merits further study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.18202","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T12:52:54Z","timestamp":1741611174000},"page":"957-967","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Why do people still make anti\u2010D over 50\u2009years after the introduction of Rho(D) immune globulin? 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