Perinatal outcomes in RhD-negative pregnant women in Japan
Managing RhD-negative pregnancies is vital for preventing hemolytic disease of the fetus and newborn, which occurs when RhD-negative mothers develop anti-D antibodies after exposure to RhD-positive fetal blood. This retrospective cohort study evaluated the proportion of RhD-negative pregnancies and newborns in Japan by assessing current management practices and outcomes. This study included RhD-negative pregnant women who delivered at 22 weeks or later at 47 Japanese facilities between April 2018 and March 2023. Pregnancies with unknown newborn RhD status were excluded. Data were obtained from medical records. Among the 1088 RhD-negative women, 1062 met the inclusion criteria. RhD-negative pregnancies comprised 0.71% of the total cohort, with 8.7% RhD-negative newborns. Anti-D immunoglobulin was administered in 96.5% of pregnancies, with a maternal spontaneous sensitization rate of 0.6% before 28 weeks and no sensitization detected from 28 weeks to postpartum. Sensitized RhD-negative women had higher cesarean section, preterm delivery, and neonatal hemolytic anemia rates than the non-sensitized group, leading to increased neonatal intensive care unit admissions. Despite the low incidence of RhD-negative pregnancies, this study underscores the need for tailored management strategies, suggesting that non-invasive prenatal diagnosis of fetal RhD status could prevent unnecessary anti-D immunoglobulin administration, improving outcomes and resource utilization in Japan.
Authors
- Noriko Kato
- Emiko Hara
- Harada Aya
- Tomoiki Kiyama
- Emiko Abe
- Chinami Horiuchi (ORCID: https://orcid.org/0000-0002-3175-9015)
- Susumu Yoshida (ORCID: https://orcid.org/0000-0002-5135-7507)
- Yoshinobu Fujimoto
- Shunichiro Tsuji (ORCID: https://orcid.org/0000-0003-3945-6817)
- Hideki Sugii (ORCID: https://orcid.org/0000-0002-8790-7208)
- Saori Tanaka (ORCID: https://orcid.org/0000-0002-7001-5051)
- Toshiyuki Sado
- Tokumasa Suemitsu (ORCID: https://orcid.org/0000-0001-9600-8450)
- Yuko Matsubara
- Shunsuke Tamaru (ORCID: https://orcid.org/0000-0001-7340-6931)
- Maiko Sagawa
- Hiroshi Katagiri (ORCID: https://orcid.org/0000-0003-4100-9995)
- Saburo SHIBUKAWA
- Osamu Samura (ORCID: https://orcid.org/0000-0002-7249-1537)
- Yurika Mukai
- Miyoko Waratani (ORCID: https://orcid.org/0000-0003-3353-6410)
- Hitoshi Matsui (ORCID: https://orcid.org/0000-0002-0376-0879)
- Norihiko Kikuchi (ORCID: https://orcid.org/0009-0003-0276-248X)
- Noriyuki Nakamura (ORCID: https://orcid.org/0000-0002-1870-7632)
- Saya Tsukahara
- Aikou Okamoto (ORCID: https://orcid.org/0000-0002-5079-0464)
- Hiromi Nagase (ORCID: https://orcid.org/0000-0001-8626-3650)
- Tomomi Shiga (ORCID: https://orcid.org/0000-0003-2115-7536)
- Makiko Egawa (ORCID: https://orcid.org/0000-0002-1609-1360)
- Sayuri Nakanishi (ORCID: https://orcid.org/0000-0002-3694-4340)
- Sota Takahashi
- Ken Takahashi (ORCID: https://orcid.org/0000-0002-7310-2257)
- Mika Sato (ORCID: https://orcid.org/0009-0002-2432-0503)
- Hiroshi Sato (ORCID: https://orcid.org/0000-0001-7706-158X)
- Jun Sasahara (ORCID: https://orcid.org/0000-0001-8399-5522)
- Mariko Serizawa
- Kazuhiro Kajiwara
- Kaori Fukuta
- Chiyo Tamamura
- Akihiro Kawashima (ORCID: https://orcid.org/0000-0002-3501-4854)
- Sumiko Hara
- Showa Aoki
- Hiroyuki Sasaki (ORCID: https://orcid.org/0000-0002-7735-5761)
- Kazuhisa Maeda
- Tomoko Yamamoto
- Yoshifumi Kasuga (ORCID: https://orcid.org/0000-0003-2395-9591)
- Tadatsugu Kinjo
- Keiichiroh Akabane
Institutions
- Jikei University School of Medicine (JP)
- SHOWA Medical University (JP)
- Shiga University of Medical Science (JP)
- Tokyo University of Science (JP)
- Saga University (JP)
- Keio University (JP)
- Hachinohe Gakuin University (JP)
- Yokohama City University Medical Center (JP)
- University of the Ryukyus (JP)
- Kyoto Prefectural University of Medicine (JP)
- Toyonaka Municipal Hospital (JP)
- Hiratsuka City Hospital (JP)
- San-ikukai Hospital (JP)
- Osaka Women's and Children's Hospital (JP)
- Chigasaki Rehabilitation College (JP)
- Chiba University Hospital (JP)
- Gifu University Hospital (JP)
- University of Fukui Hospital (JP)
- Ehime University Hospital (JP)
- Tottori Prefectural Kousei Hospital (JP)
- Kameda Medical Center (JP)
- Kanagawa Children's Medical Center (JP)
- Saitama Medical University Hospital (JP)
- Kitakyushu Municipal Medical Center (JP)
- Hiroshima University Hospital (JP)
- Matsue Red Cross Hospital (JP)
- Shinshu University Hospital (JP)
- Sakakibara Hospital (JP)
- National Center For Child Health and Development (JP)
- Iwakuni Medical Center (JP)
- Hyogo Prefectural Amagasaki General Medical Center (JP)
- Hokkaido University Hospital (JP)
- Anjo Kosei Hospital (JP)
- Ehime Prefectural Central Hospital (JP)
- Okayama Medical Center (JP)
- Japanese Red Cross Nagoya Daini Hospital (JP)
- Kure Medical Center (JP)
- Shikoku Medical Center for Children and Adults (JP)
- Kouseiren Takaoka Hospital (JP)
- Hamamatsu Medical Center (JP)
- Ehime University (JP)
- Yokohama City University (JP)
Publication Details
- Journal
- Scientific Reports
- Published
- 2025-03-22
- DOI
- https://doi.org/10.1038/s41598-025-94487-z
- Citations
- 1
- Primary Topic
- Blood groups and transfusion
- Type
- article
- Field-Weighted Citation Impact
- 1.77
Funders
- Japan Society for the Promotion of Science