This study sought to quantify the magnitude of Rh disease reduction occurring secondary to Rh prophylaxis and other determinants.
Outcomes considered included maternal Rh sensitization. neonatal Rh disease, and perinatal deaths from Rh disease.
Analysis was based on Poisson regression modeling of ecological data from Manitoba, Canada, and conditional probability modeling.
The ecological analysis showed that changes in birth order and Rh prophylaxis resulted m 24% (95% confidence interval [CI] 1%, 42%) and 69% (95% CI ? 61%, 76%) decreases, respectively, in Rh sensitizations (D aud non-D) in Manitoba beween 1963 and 1988.
Rh prophylaxis and nonprogram factors were responsible for 83% (95% CI=44%, 95%) and 78% (95%. CI=42%, 91%), respectively, of the reduction in perinatal deaths from Rh disease.
Similar results were obtained with conditional probability modeling, which also provided estimates for the effects of changes in abortion rates and racial composition.
In addition to Rh prophylaxis changes in other determinants were responsible for an important fraction of the decline in Rh disease.
These results provide a historical perspective on the conquest of Rh disease and also have important implications for public health policy, particularly in developing countries.
Mots-clés Pascal : Anémie hémolytique, Isoimmunisation, Foetomaternel, Système Rh, Méthodologie, Evaluation, Prévention, Probabilité, Pronostic, Nouveau né, Homme, Analyse statistique, Modèle statistique, Canada, Amérique du Nord, Amérique, Hémopathie
Mots-clés Pascal anglais : Hemolytic anemia, Isoimmunization, Fetomaternal, Rh-System, Methodology, Evaluation, Prevention, Probability, Prognosis, Newborn, Human, Statistical analysis, Statistical model, Canada, North America, America, Hemopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0150597
Code Inist : 002B30A01A1. Création : 21/07/1998.