A prospective study of routine antenatal enzyme antibody screening demonstrates lack of clinical value in predicting haemolytic disease of the newborn

• Published in: British journal of haematology Vol. 106; no. 3; pp. 824 - 826
• Main Authors: Clark, D., Greiss, M. A., Urbaniak, S. J.
• Format: Journal Article
• Language: English
• Published: Oxford, U.K. and Cambridge, USA Blackwell Science Ltd 01-09-1999; Blackwell
• Subjects: antibody screening; Autoantibodies - analysis; Biological and medical sciences; enzyme techniques; Enzymes - immunology; Erythroblastosis, Fetal - diagnosis; Female; Gynecology. Andrology. Obstetrics; haemolytic disease of the newborn; Humans; Immunoenzyme Techniques - methods; Infant, Newborn; Management. Prenatal diagnosis; Medical sciences; Predictive Value of Tests; Pregnancy; Pregnancy. Fetus. Placenta; Prenatal Diagnosis - methods; Prospective Studies; red cell antibodies; Human; Antibody; Red blood cell; Exploration; Hemopathy; Serology; Medical screening; Pregnancy; Isoimmunization; Prenatal; Enzymatic method; Fetal diseases; Newborn diseases; Blood group; Hemolytic anemia; Newborn; Mother; Alloantibody; Predictive value; Diagnosis
• DOI: 10.1046/j.1365-2141.1999.01618.x
• EISSN: 1365-2141
• ISSN: 0007-1048

A prospective study of 7065 consecutive new pregnancies identified 230 with a positive screen, of which 27% (62/230) were ‘enzyme‐only’ antibodies. 32 of these (52%) were potentially clinically important and were all of Rh specificity: 22 anti‐E, seven anti‐Cw, two anti‐D and one anti‐c. However, only three of these enzyme‐only antibodies (one anti‐D, one anti‐c and one anti‐E) became reactive by the indirect antiglobulin test (IAT) during the course of pregnancy, and all were detected in the routine 34–36‐week maternal sample. No babies were affected, and we reaffirm that routine antibody screening by enzyme techniques is unnecessary.