Franchinard et al reported risk factors associated with hemolytic disease of the newborn (HDN) due to anti-c. The authors are from Sorbonne University and affiliated hospitals in Paris.
Patient selection: mother with anti-c and fetus positive for c-antigen
HDN occurred in 30% of pregnancies, with about a third severe.
Maternal Serum
Concentration Associated with HDN
Titer Associated with HDN
prenatal
>= 7.5 IU/mL
>= 4
at birth
>= 15 IU/mL
>= 8
IgG antibodies are needed to cross the placental barrier.
The neonate should be monitored for at least the first 30 days after delivery for signs of worsening anemia. Some infants. Almost a fifth of neonates required a transfusion in the first 3 weeks after birth.
If the neonate has persistent anemia and if the mother is breastfeeding, then the breast milk may be the source of additional anti-c.
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