| Abstract [eng] |
Hemolytic disease of the newborn, most commonly caused by a maternal immune response to the fetal Rh D antigen, remains a significant pathological condition during pregnancy and the neonatal period. It can lead to severe fetal or neonatal anemia, hyperbilirubinemia, hydrops fetalis, or even death. Although both antenatal and postnatal immunoprophylaxis are applied in Lithuania, hemolytic disease of the newborn remains a relevant pathological condition among neonates. Objectives: 1. To assess the number of hemolytic disease of the newborn cases and morbidity rate trends in Lithuania and in the Vilnius and Kaunas perinatology centers. 2. To evaluate trends in the number and prevalence of maternal sensitization cases among Rh D-negative mothers in Lithuania and in the Vilnius and Kaunas perinatology centers during 2014–2023. 3. To assess the coverage and dynamics of antenatal and postnatal Rh D immunoprophylaxis in Lithuania and in the Vilnius and Kaunas perinatology centers during 2014–2023. Methods. A retrospective data analysis was conducted using the annual “Medical Birth Data” reports published by the Institute of Hygiene and additional data obtained directly from the Institute. The number of Rh D-negative mothers from 2014 to 2020 was reconstructed based on the proportion of Rh D-negative mothers from 2021 to 2023 and the actual number of live births during 2014–2020. Statistical analysis was performed using descriptive and comparative statistical methods. The threshold for statistical significance was set at p < 0.05. Results. During 2014–2023, a total of 360 cases of hemolytic disease of the newborn due to Rh D isoimmunization were identified in Lithuania. The incidence remained stable both at the national level (p > 0.2) and in the Vilnius Perinatology Center (p > 0.08), although a slight increasing trend was observed in the latter. In contrast, a statistically significant decrease was noted in the Kaunas Perinatology Center (p = 0.0283). The sensitization rate in Lithuania declined from 2.76 to 0.98 cases per 1,000 Rh D-negative mothers. In the Vilnius center, the change was not statistically significant (p > 0.1), while in Kaunas the decrease was statistically significant (p = 0.005). In both Lithuania overall and the Vilnius and Kaunas centers, the coverage of antenatal and postnatal immunoprophylaxis increased significantly during the study period (p < 0.005). Conclusions. Over the past decade, the incidence of hemolytic disease of the newborn in Lithuania has remained stable, although notable regional differences were identified. The decrease in sensitization and the expansion of immunoprophylaxis suggest a declining risk of hemolytic disease of the newborn. |
