Should cell-free DNA testing be used to target antenatal rhesus immune globulin administration?

Kimberly K. Ma, Maria Rodriguez, Yvonne W. Cheng, Mary E. Norton, Aaron Caughey

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective: To compare the rates of alloimmunization with the use of cell-free DNA (cfDNA) screening to target antenatal rhesus immune globulin (RhIG) prenatally, versus routine administration of RhIG in rhesus D (RhD)-negative pregnant women in a theoretic cohort using a decision-analytic model. Methods: A decision-analytic model compared cfDNA testing to routine antenatal RhIG administration. The primary outcome was maternal sensitization to RhD antigen. Sensitivity and specificity of cfDNA testing were assumed to be 99.8% and 95.3%, respectively. Univariate and bivariate sensitivity analyses, Monte Carlo simulation, and threshold analyses were performed. Results: In a cohort of 10 000 RhD-negative women, 22.6 sensitizations would occur with utilization of cfDNA, while 20 sensitizations would occur with routine RhIG. Only when the sensitivity of the cfDNA test reached 100%, the rate of sensitization was equal for both cfDNA and RhIG. Otherwise, routine RhIG minimized the rate of sensitization, especially given RhIG is readily available in the United States. Conclusions: Adoption of cfDNA testing would result in a 13.0% increase in sensitization among RhD-negative women in a theoretical cohort taking into account the ethnic diversity of the United States’ population.

Original languageEnglish (US)
JournalJournal of Maternal-Fetal and Neonatal Medicine
DOIs
StateAccepted/In press - Aug 13 2015

Fingerprint

Immunoglobulins
DNA
Pregnant Women
Mothers
Antigens
Sensitivity and Specificity
Population

Keywords

  • Cell-free DNA
  • Rh alloimmunization
  • RhIG

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

Cite this

Should cell-free DNA testing be used to target antenatal rhesus immune globulin administration? / Ma, Kimberly K.; Rodriguez, Maria; Cheng, Yvonne W.; Norton, Mary E.; Caughey, Aaron.

In: Journal of Maternal-Fetal and Neonatal Medicine, 13.08.2015.

Research output: Contribution to journalArticle

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