Objective To investigate the incidence of anti-D antibody in Rh-negative pregnant women. Methods Rh (D) blood group and serum anti-D antibody were tested by micro column gel method. PCR detection of RHD1227A was used for identification of DEL and truly Rh-negative phenotypes. Results Totally 196 cases of Rh-negative pregnant women were observed. Among them, 56 cases without history of pregnancy had anti-D positive rate of 5.4%(3/56);77 cases with pregnancy history (excluding the history of birth) had anti-D positive rate of 7.8% (6/77), and 63 cases with childbearing history had anti-D positive rate of 30.2% (19/63); the overall positive rate of anti-D antibody was 14.3% (28/196). There were 41 cases of DEL phenotype detected in all the samples, but anti-D antibody was not found, even in the 12 pregnant women who had a history of childbearing. After excluding DEL phenotype, the total anti-D positive rate in the 155 truly Rh-negative cases was 18.1% (28/155). Among them, the positive rate of anti-D antibody was 6.4%(3/47) in the women with no history of pregnancy, 9.7%(6/62) in the women with pregnancy history and 41.3% (19/46) in the cases with reproductive history. Conclusions Nearly half of the truly Rh-negative pregnant women with childbearing history have immune response to D antigen. And the pregnant women of DEL phenotype do not produce anti-D antibody.%目的 综合分析不同状况Rh阴性孕妇抗-D抗体的发生率.方法 采用微柱凝胶卡方法鉴定Rh(D)血型以及测定孕妇血清抗-D抗体,PCR方法检测RHD1227A等位基因鉴别我国汉族Rh阴性个体中的一种变异体"DEL型"和真实Rh阴性表型.结果 共观察196例Rh阴性孕妇,抗-D检出率14.3%(28/196);其中56例病历记录无妊娠史,抗-D阳性率5.4%(3/56);77例有妊娠史(有生育史除外),抗-D阳性率7.8%(6/77);余63例有生育史,抗-D阳性率30.2%(19/63).所有样本中检出变异体DEL型41例,均未检测到抗-D抗体.排除DEL按真实Rh阴性计算(155例),抗-D阳性率18.1%(28/155);无妊娠史者阳性率6.4%(3/47);有妊娠史者阳性率上升为9.7%(6/62);有生育史者抗-D阳性率则达41.3%(19/46).结论 近半数有生育史的真实Rh阴性孕妇发生D抗原同种免疫反应,DEL型孕妇不因妊娠和生育产生抗-D抗体.
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