The detection of anti-D in Rho (D)-negative infants born of Rho (D)-positive mothers.

It has not been determined whether Rho (D)-negative infants born of Rho (D)-positive mothers are sensitized during gestation or during parturition. Sensitization before use precludes the efficacious use of human Rho immune globulin as a prophylactic. The purpose of the present study is to identify the time of sensitization. Cord blood was collected from the placentas of 68 Rho (D)-negative infants whose mothers were Rho (D)-positive. Sixty-three of the 68 infants had one blood sample obtained between 1 and 9 months later. The paired samples were analyzed for anti-D by standard Coombs test and by automated antibody detection techniques. With the technique of automated antibody detection, we have been unable to demonstrate antibody in cord blood of the Rho (D)-negative infants of whom at least 7 of 63 (11%) had detectable anti-D between 1 and 9 months of age. These data show that Rho (D)-negaitve infants do not have detectable antibody at birth but may develop detectable anti-D in the first months of life. This observation suggests that the sensitizing dose of Rho (D) antigen occurs at parturition rather than during gestation.