Maternal sickle cell anemia and neonatal isoimmunization.

OBJECTIVE

To study the risk of alloimmunization in pregnant women with sickle cell disease (SCD) and of isoimmunization in their offspring.

METHOD: Thirty mothers with SCD were studied and their 35 neonates (group 1) were compared with 538 infants of mothers without hemoglobinopathies (group 2).

RESULT: Six mothers with SCD developed alloantibodies. There was no correlation with maternal age (P = 0.6), parity (P = 0.18) or blood transfusions (P = 0.4). The risk of alloimmunization by transfusion was 20%. Six neonates were isoimmunized, a higher incidence than in group 2 (P = 0.02; relative risk 3.07). Five had ABO incompatibility and only one had anti-c isoimmunization. All had reticulocytosis, jaundice and required phototherapy, one developed anemia but none required blood transfusion.

CONCLUSION

Although alloimmunization was common in mothers with SCD and isoimmunization in their offspring, it was rarely due to non-ABO alloantibody. There was no significant neonatal morbidity.