Scientific Reports (Mar 2025)
Perinatal outcomes in RhD-negative pregnant women in Japan
- Ken Takahashi,
- Susumu Yoshida,
- Showa Aoki,
- Saori Tanaka,
- Akihiro Kawashima,
- Kazuhiro Kajiwara,
- Noriko Kato,
- Hitoshi Matsui,
- Mariko Serizawa,
- Shunichiro Tsuji,
- Tomoko Yamamoto,
- Tadatsugu Kinjo,
- Noriyuki Nakamura,
- Maiko Sagawa,
- Mika Sato,
- Emiko Abe,
- Sayuri Nakanishi,
- Yoshinobu Fujimoto,
- Sota Takahashi,
- Hiroyuki Sasaki,
- Yurika Mukai,
- Sumiko Hara,
- Kaori Fukuta,
- Norihiko Kikuchi,
- Emiko Hara,
- Tomomi Shiga,
- Chinami Horiuchi,
- Toshiyuki Sado,
- Yuko Matsubara,
- Keiichiroh Akabane,
- Aya Harada,
- Hiromi Nagase,
- Kazuhisa Maeda,
- Hiroshi Katagiri,
- Jun Sasahara,
- Hirokazu Sugii,
- Shunsuke Tamaru,
- Miyoko Waratani,
- Saya Tsukahara,
- Shohei Shibukawa,
- Tomoiki Kiyama,
- Yoshifumi Kasuga,
- Makiko Egawa,
- Hiroshi Sato,
- Chiyo Tamamura,
- Tokumasa Suemitsu,
- Aikou Okamoto,
- Osamu Samura
Affiliations
- Ken Takahashi
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine
- Susumu Yoshida
- Department of Obstetrics and Gynecology, Toyonaka Municipal Hospital
- Showa Aoki
- Department of Obstetrics and Gynecology, Uji-Tokushukai Medical Center
- Saori Tanaka
- Department of Obstetrics and Gynecology, San-ikukai Hospital
- Akihiro Kawashima
- Department of Obstetrics and Gynecology, Showa University School of Medicine
- Kazuhiro Kajiwara
- National Center for Child Health and Development
- Noriko Kato
- Department of Obstetrics and Gynecology, Japanese Red Cross Aichi Medical Center Nagoya Daini Hospital
- Hitoshi Matsui
- Department of Obstetrics and Gynecology, Chigasaki City Hospital
- Mariko Serizawa
- Department of Obstetrics and Gynecology, Hamamatsu Medical Center
- Shunichiro Tsuji
- Department of Obstetrics and Gynecology, Shiga University of Medical Science
- Tomoko Yamamoto
- Department of Obstetrics and Gynecology, Faculty of Medicine, Saga University
- Tadatsugu Kinjo
- Department of Obstetrics and Gynecology, University of the Ryukyus Hospital
- Noriyuki Nakamura
- Department of Obstetrics and Gynecology, Anjo Kosei Hospital
- Maiko Sagawa
- Department of Obstetrics and Gynecology, NHO Kure Medical Center and Chugoku Cancer Center
- Mika Sato
- Department of Obstetrics and Gynecology, Chiba University Hospital
- Emiko Abe
- Department of Obstetrics and Gynecology, Ehime Prefectural Central Hospital
- Sayuri Nakanishi
- Perinatal Center for Maternity and Neonate, Yokohama City University Medical Center
- Yoshinobu Fujimoto
- Department of Obstetrics and Gynecology, Hiratsuka City Hospital
- Sota Takahashi
- Department of Obstetrics and Gynecology, Hachinohe City Hospital
- Hiroyuki Sasaki
- Department of Obstetrics and Gynecology, Saiseikai Yokohamashi Tobu Hospital
- Yurika Mukai
- Department of Obstetrics and Gynecology, Hiroshima University Hospital
- Sumiko Hara
- Department of Obstetrics and Gynecology, Tokyo Adventist Hospital
- Kaori Fukuta
- Department of Obstetrics and Gynecology, Kouseiren Takaoka Hospital
- Norihiko Kikuchi
- Department of Obstetrics and Gynecology, Shinshu University Hospital
- Emiko Hara
- Department of Obstetrics and Gynecology, Kitakyushu Municipal Medical Center
- Tomomi Shiga
- Department of Obstetrics and Gynecology, Gifu University Hospital
- Chinami Horiuchi
- Department of Obstetrics and Gynecology, Sakakibara Heart Institute
- Toshiyuki Sado
- Department of Obstetrics and Gynecology, Nara Prefectural General Medical Center
- Yuko Matsubara
- Department of Obstetrics and Gynecology, Ehime University Hospital
- Keiichiroh Akabane
- Department of Obstetrics and Gynecology, Hokkaido University Hospital
- Aya Harada
- Department of Obstetrics and Gynecology, Japan Baptist Hospital
- Hiromi Nagase
- Department of Obstetrics and Gynecology, Kanagawa Children’s Medical Center
- Kazuhisa Maeda
- Department of Obstetrics and Gynecology, Shikoku Medical Center for Children and Adults
- Hiroshi Katagiri
- Department of Obstetrics and Gynecology, Masuda Red Cross Hospital
- Jun Sasahara
- Department of Obstetrics and Gynecology, Osaka Women’s and Children’s Hospital
- Hirokazu Sugii
- Department of Obstetrics and Gynecology, NHO Iwakuni Clinical Center
- Shunsuke Tamaru
- Department of Obstetrics and Gynecology, Saitama Medical University Hospital
- Miyoko Waratani
- Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine Hospital
- Saya Tsukahara
- Department of Obstetrics and Gynecology, NHO Okayama Medical Center
- Shohei Shibukawa
- Department of Obstetrics and Gynecology, Matsue Red Cross Hospital
- Tomoiki Kiyama
- Department of Obstetrics and Gynecology, Tottori Prefectural Kosei Hospital
- Yoshifumi Kasuga
- Department of Obstetrics and Gynecology, Keio University School of Medicine
- Makiko Egawa
- Department of Nutrition and Metabolism in Cardiovascular Disease, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo
- Hiroshi Sato
- Department of Obstetrics and Gynecology, Hyogo Prefectural Amagasaki General Medical Center
- Chiyo Tamamura
- Department of Obstetrics and Gynecology, University of Fukui Hospital
- Tokumasa Suemitsu
- Department of Obstetrics and Gynecology, Kameda Medical Center
- Aikou Okamoto
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine
- Osamu Samura
- Department of Obstetrics and Gynecology, The Jikei University School of Medicine
- DOI
- https://doi.org/10.1038/s41598-025-94487-z
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 10
Abstract
Abstract 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.
Keywords
- RhD-negative pregnancies
- Hemolytic disease of the fetus and newborn
- Anti-D immunoglobulin
- Maternal sensitization
- Non-invasive prenatal diagnosis
- Neonatal hemolytic anemia
