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Postdelivery levels of anti‐D IgG prophylaxis in D– mothers depend on maternal body weight
Author(s) -
Woelfer Brigitte,
Schuchter Katharina,
Janisiw Michael,
Hafner Erich,
Philipp Karl,
Panzer Simon
Publication year - 2004
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2004.03287.x
Subject(s) - medicine , body mass index , offspring , pharmacokinetics , body weight , serum concentration , bioavailability , pregnancy , obstetrics , endocrinology , physiology , biology , pharmacology , genetics
BACKGROUND: Current recommendations for anti‐D prophylaxis for women who deliver a D+ offspring vary from country to country, and the introduction of new reagents require pharmacokinetic studies that show serum levels after the injection. Serum levels of anti‐D may depend on the maternal body mass index (BMI). STUDY DESIGN AND METHODS: Serum concen‐trations of total anti‐D IgG and IgG1‐4 subclasses were determined by flow cytometry in 26 D– women, who had received prophylaxis after delivery of a D+ offspring. Blood samples were drawn on Days 1, 2, 3, and 14 after injection, and the BMI was recorded. RESULTS: Anti‐D levels increased continuously in all women during the first 3 days. The increase was significantly affected by the BMI if higher than 27 kg per m 2 (p < 0.001). The higher the BMI, the less was the increase of serum anti‐D. Mean peak levels 72 hours after injection was 89 ng per mL in lean women, but estimated levels were 28 to 60 percent lower in women with a BMI of 28 to 40 kg per m 2 . The effect of a BMI higher than 27 kg per m 2 on anti‐D was not gradual but progressive. Similarly, the BMI affected serum concentrations of anti‐D subclasses IgG1‐4 (p < 0.001). CONCLUSION: The BMI needs consideration for the adjustment of the dosage of anti‐D, provided its bio‐ availability to suppress alloimmunization is reflected by measurable amounts in the serum.