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Transfusion. 2019 Jun 10. doi: 10.1111/trf.15394. [Epub ahead of print]

Frequency and characterization of RHD variants in serologically D- Surinamese pregnant women and D- newborns.

Author information

1
Scientific Research Center Suriname, Academic Hospital Paramaribo, Paramaribo, Suriname.
2
Department of Pediatrics, Academic Hospital Paramaribo, Paramaribo, Suriname.
3
Faculty of Medical Sciences, Anton the Kom University of Suriname, Paramaribo, Suriname.
4
Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands.
5
Department of Experimental Immunohematology, Sanquin Research, Amsterdam, The Netherlands.
6
Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, The Netherlands.
7
Department of Pediatrics, Diakonessen Hospital, Paramaribo, Suriname.

Abstract

BACKGROUND:

Numerous RHD variant genes affect the expression of D on the red blood cell surface. In Suriname, 4.3% of pregnant women were D-, ranging from virtually zero to 7% among ethnic groups. Characterization of RHD variants, which are associated with a variable potential to induce anti-D, is of practical clinical importance especially in case of limited access to preventive measures. Here we report on the occurrence of RHD variant genes in Surinamese serologically D- pregnant women and their D- newborns from different ethnic groups.

STUDY DESIGN AND METHODS:

The RheSuN study is a cross-sectional cohort study in D- pregnant women and their newborns, who visited hospitals in Paramaribo, Suriname, during routine pregnancy care. The presence of RHD variants was investigated using quantitative polymerase chain reaction targeting RHD Exons 5 and 7 and RH-multiplex ligation-dependent probe amplification.

RESULTS:

Seven RHD variant genes were detected in 35 of 84 women and four RHD variant genes in 15 of 36 newborns. The RHD*03 N.01 and RHD*08 N.01 variants represented 87% of a total of 62 variant genes. Variants were comparably frequent among ethnicities. In four cases genotyping would have changed anti-D prophylaxis policy: one woman with a RHD*01EL.01 variant, not associated with anti-D formation and three D- newborns with RHD*09.01 and RHD*09.03.01 variants, potentially capable of inducing anti-D.

CONCLUSION:

RHD variants at risk for anti-D are common among serologic D- individuals from African descent in Suriname. While genotyping D- women has limited added value, it may be considered in newborns from D- women.

PMID:
31183885
DOI:
10.1111/trf.15394

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