Hemolytic Disease of Fetus and Newborn: A 24-Year Nationwide Cohort Study on Incidence, Management, and Outcomes

Background: Hemolytic disease of the fetus and newborn (HDFN) can cause severe prenatal and postnatal outcomes. The main objective of this study is to characterize the clinical impact of HDFN on pregnant women and their newborns. Methods: A retrospective cohort study was performed on de-identified data extracted from Maccabi Healthcare Services (MHS), a large nationwide health organization. The cohort included women and newborns diagnosed with HDFN between January 1998 and December 2021. Cohort characteristics and outcomes are described. Results: Over the 24-year study period, the incidence rate of HDFN among pregnant women remained stable, while the incidence rate among newborns declined. Severe HDFN was diagnosed in 22 (30.1%) of 73 HDFN-affected pregnancies. Among 450 HDFN newborns, one-third were diagnosed with anemia or jaundice, and 5 cases of kernicterus were observed. Conclusions: Severe prenatal and postnatal outcomes were observed in cases of HDFN. Further studies are needed to evaluate treatment regimens and to assess the association between treatment management and both short- and long-term outcomes.