Epidemiology

About 15% of the white population has an RhD-negative blood type.[3] Population data suggest that the incidence of RhD negativity is highest among Basques (36%).[3] Around 6% to 7% of black people and less than 1% of American Indian and Asian people have an RhD-negative blood type.[3][4]​ Rh alloimmunisation due to RhD has declined markedly as immunoprophylaxis has become routine practice.[5][6]​​ Societal factors, such as delayed childbearing and smaller families, may also have contributed to this decline.[5]

In the UK, about 16% of the white population is RhD-negative.[7]​​ In 2013-2014, about 15% of births in England were to RhD-negative women; about 40% of these women had an RhD-negative fetus.[8]

The estimated global prevalence of Rh haemolytic disease is 276/100,000 live births; in countries with well-established perinatal-neonatal care, the prevalence is approximately 2.5/100,000 live births.[9]​ One survey in Canada estimated that 8/100,000 infants are affected by maternal anti-D antibodies.[10] ​ In the US, the reported incidence of Rh haemolytic disease ranges from 1.0 to 6.8/1000 live births; the higher rate may reflect improved identification and reporting of sensitised women and increasing prevalence of atypical, non-RhD antibodies for which immunoprophylaxis regimens are unavailable.[11][12][13]

The relative frequency has been reported for several of these non-RhD antibodies.[11] In a large prospective series including over 300,000 consecutive patients, about 1% of pregnant women had alloantibodies detected in the first trimester.[14] Of these, the prevalence of alloantibodies other than anti-D was 328/100,000, of which 191/100,000 implied a risk for occurrence of haemolytic disease of the fetus and newborn as the father carried the antigen. The most common non-anti-D antibodies were anti-K and anti-c.[14]

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