Chapter 29. Immune Anti-D in pregnancy 2025 - Supplementary Information

Additional data tables and analysis not included in the main 2025 Annual SHOT Report.

No previous pregnancy (NPP) n=14

There were 14 new NPP cases in 2025, cumulative to 166 cases analysed by SHOT since 2012.

Table 29.1: Time of first detection of alloimmune anti-D

Gestation when alloimmune anti-D was first detected	Number of new cases 2025	Number of cases cumulative to 2025
Before 28 weeks	3	28
At or after 28 weeks, before birth	10	65
At birth	1	65
Other	0	3*
No information	0	5
Total	14	166

*Alloimmune anti-D was detected 2 weeks postpartum after a large FMH of 101.5mL at birth, managed correctly. This antibody was still detected after 8 months, confirming the alloimmunisation. Alloimmune anti-D was detected 6 months postpartum after large FMH of 12.7mL at birth, managed correctly. Alloimmune anti-D was detected 3 months postpartum prior to a surgical procedure, twin pregnancy managed correctly.

Table 29.2: Weight at booking

Booking weight	Number of new cases 2025	Number of cases cumulative to 2025
<68 Kg	2	57
68 – 80 Kg	4	21
>80 Kg (obese)	1	21
No information	7	67
Total	14	166

Table 29.3: BMI at booking

Booking BMI	Number of new cases 2025	Number of cases cumulative to 2025
<18.5	1	1
18.5 – 24.9 Kg	4	10
15 – 29.9	4	7
>30 (obese)	5	10
No information	0	6
Total	14	34

Table 29.4: cffDNA testing

cffDNA test	Number of cases 2025	Details
Not performed	6	3 No guideline or pathways for antenatal fetal D screening test 1 Late booker (26 weeks) 2 No reason provided
Performed	6	5 predicted D-positive 1 predicted D-negative
No information	2	N/A
Total	14	N/A

Table 29.5: Details of RAADP in eligible cases i.e., alloimmune anti-D detected ≥28 weeks gestation (n=11)

RAADP regimen	Number of new cases 2025	Number of cases cumulative to 2025
Single dose (1500iu) at 28-30 weeks	7	104
Single dose (1500iu) >30 weeks	0	4
Two dose regiment (2x500iu)	0	1
Not given	4	26
Unknown	0	2
Total	11	137

Previous pregnancy (PP) n=59

The index pregnancy in these cases refers to the current pregnancy; the pregnancy in which alloimmune anti-D was first detected.

There were 59 new cases in 2025, cumulative to 502 cases analysed by SHOT since 2012.

Table 29.6: Time of first detection of alloimmune anti-D

Gestation when alloimmune anti-D was first detected	Number of new cases 2025	Number of cases cumulative to 2025
Before or at 12 weeks	23*	189
After 12 weeks to 28 weeks (incl. late booking)	8	70
At or after 28 weeks	14	152
At birth	9	72
Other	5**	19***
Total	59	502

*1 case the gestation was reported as ‘at booking (up to 13 weeks gestation)’, but gestation was not provided. ;
**2 cases immune anti-D identified pre-operatively, 3 cases at a follow-up appointment post-natal, 2 of these after a large fetomaternal haemorrhage volume (FMH) at birth;
***1 case alloimmune anti-D identified >1 year post-birth when woman attended for a gynaecology procedure, 3 preoperative assessment following pregnancy, 3 at planned follow up of a large FMH at birth where correct dose of anti-D Ig had been given, 7 unknown.

Details of birth in the pregnancy immediately preceding index (current) pregnancy

Table 29.7: Outcome of the preceding pregnancy

Outcome of preceding pregnancy	Number of cases 2025	Details
Live births	25	17 D-positive 3 D-negative 5 unknown neonatal D-status*
Other	34	1 Miscarriage 9 weeks gestation 1 Miscarriage 13 weeks gestation 1 IUD at 24 weeks gestation 31 No information

IUD = intrauterine death
*2 cases cord samples were not taken as the women were treated as D-positive (D variant identified in the index pregnancy)

Table 29.8: Method of birth of preceding pregnancy (for women and birthing people who carried to a live birth, in 2025 n=25)

Type	Number of new cases 2025	Number of cases cumulative to 2025
Vaginal	7	181
Instrumental	1	18
Elective caesarean section	8	55
Emergency caesarean section	7	56
No information	2	72
Total	25	382

Table 29.9: Gestation at birth of preceding pregnancy (for women and birthing people who carried to a live birth, in 2025 n=25)

Gestation at birth (weeks)	Number of new cases 2025
40 weeks or less	21
More than 40 weeks	2
No information	2
Total	25

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