Relation between Couples' Blood Group and RH with Abortions in women of reproductive age: A Case-Control Study

Document Type : Original Article

Authors

1 Assistant Professor, Department of Midwifery, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.

2 Instructor, Department of Midwifery, School of Nursing and Midwifery, Gonabad University of Medical Sciences, Gonabad, Iran.

3 B.Sc. in Health Care, School of Health, Gonabad University of Medical Sciences, Gonabad, Iran.

Abstract

Introduction: Abortion is a common complication of pregnancy. Understanding the factors affecting abortion plays an important role in preventing and improving pregnancy outcomes. Since the relationship between parents' blood group and RH in the incidence of abortion is controversial, this study was performed with aim to investigate the relationship between parents' blood group and abortion in pregnant mothers in Gonabad.
Methods: This case-control study was performed in 2019 on 450 pregnant women referring to the sonography clinics of Gonabad in two groups of abortion and healthy pregnancy less than 20 weeks. Blood groups of the subjects and their spouses were evaluated. The tools included a checklist of personal and midwifery information and the use of cell type method (tube method) to determine the blood group of individuals. Data were analyzed by SPSS statistical software (version 20) and Chi-square, independent t-test, one-way analysis of variance and logistic regression. P < 0.05 was considered statistically significant.
Results: According to the findings, the most common blood type in all women was O (case group 30% and control group 63.33%) and the most common blood type in their husbands (case group 21.33% and control group 32.33%). Blood group AB was the lowest blood group in mothers (case group 14% and control group 32.66%) and fathers (case group 14% and control group 16%) The risk of spontaneous abortion was higher in women with blood type A than other ABO blood groups (p <0.05). The most common Rh blood group in women was Rh positive (77.3% in mothers in the case group and 82.33% in the control group). Also, the most common Rh blood group in fathers was Rh-positive (88% in the fathers of the case group and 6% in the control group). No association was found between abortion and parental RH. ABO blood incompatibility between parents was associated with the risk of spontaneous abortion (p <0.001).
Conclusion: ABO blood incompatibility between parents is associated with the risk of spontaneous abortion. The risk of spontaneous abortion in women with blood group A is higher than in other ABO blood groups. Parental RH is not associated with abortion.

Keywords


  1. Jamilian H, Jamilian M, Soltany Sh. The Comparison of Quality of Life and Social Support among Fertile andInfertile Women. Patient Saf Qual Improv 2017; 5(2):521-525.
  2. Ardekani ZB, Akhondi MM, Sadeghi MR, Sadri-Ardekani H. The necessity of a comprehensive study on abortion in Iran. Journal of Reproduction & Infertility 2005; 6(4).
  3. Reardon DC. The abortion and mental health controversy: A comprehensive literature review of common ground agreements, disagreements, actionable recommendations, and research opportunities. SAGE Open Med 2018; 6:2050312118807624.
  4. Cunningham FG, leveno KJ, Bloom SL, Hauth JC, Rouse D, Spong CY. Williams Obstetrics. 23nd ed. New York: McGraw-Hill Professional; 2010.
  5. Sedgh G, Bearak J, Singh S, Bankole A, Popinchalk A, Ganatra B, et al. Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends. The Lancet 2016; 388(10041):258-67.
  6. World Health Organization. Packages of interventions for family planning, safe abortion care, maternal, newborn and child health. WHO; 2010.
  7. Abdoljabbari M, Karamkhani M, Saharkhiz N, Pourhosseingholi M, Khoubestani MS. Study of the Effective Factors in Women’s Decision to Make Abortion and Their Belief and Religious Views in this Regard. J Res Religion Health 2016; 2(4):44-54.
  8. Chan RL, Olshan AF, Savitz DA, Herring AH, Daniels JL, Peterson HB, et al. Severity and duration of nausea and vomiting symptoms in pregnancy and spontaneous abortion. Human reproduction 2010; 25(11):2907-12.
  9. Nazarpour S, Tehrani FR, Simbar M, Azizi F. Thyroid dysfunction and pregnancy outcomes. Iranian journal of reproductive medicine 2015; 13(7):387-96.
  10. Maghsoudi R, Mirhosseini M. Spontaneous abortion and anti-thyroid antibodies in mother’s serum. Life Science Journal 2014; 11(SPEC.):41-4.
  11. Rahbar N, Ghorban R, Moazen S, Setoodeh Asl N. Association between spontaneous abortion and general health condition. Iran J Obstet Gynecol Infertil 2010;13(1):8-13.
  12. Hu X, Miao M, Bai Y, Cheng N, Ren X. Reproductive factors and risk of spontaneous abortion in the Jinchang Cohort. International Journal of Environmental Research and Public Health 2018; 15(11):2444.
  13. Pourjafari H, Hashemzadeh Chaleshtori M, Arab M. frequencies of antigens and their alleles from ABO & RH blood types in a group of women with two or more abortions. Avicenna Journal of Clinical Medicine 2004; 10(4):43-46.
  14. Hassanzadeh-Nazarabadi M, Shekouhi S, Seif N. The Incidence of Spontaneous Abortion in Mothers with Blood Group O Compared with other Blood Types. Int J Mol Cell Med 2012; 1(2):99-104.
  15. Jindal A, Basu SK. ABO blood group incompatibility differentials in reproductive performance with respect to maternal age and parity among Dawoodi Bohras of Udaipur, Rajasthan. Indian J Med Res 1981; 74:688-95.
  16. Lorigan PC, Sharma S, Bright N, Coleman RE, Hancock BW. Characteristics of women with recurrent molar pregnancies. Gynecologic oncology 2000; 78(3):288-92.
  17. Manjunatha S, Anita K. The relationship between maternal blood group and preeclampsia. Int J Reprod Contracept Obstet Gynecol 2015; 4(6):1749-52.
  18. Kashanian M, Baradaran HR, Bahasadri S, Alimohammadi R. Risk factors for pre-eclampsia: a study in Tehran, Iran. Arch Iran Med 2011; 14(6):412-5.
  19. Ghasemi N, Sheikhha MH, Davar R, Soleimanian S. ABO Bloods group incompatibility in recurrent abortion. Iranian journal of Pediatric Hematology and Oncology 2011; 1(2):62-66.
  20. Franchini M, Mengoli C, Lippi G. Relationship between ABO blood group and pregnancy complications: a systematic literature analysis. Blood Transfus 2016; 14(5):441-8.
  21. Parker RA, Bregman DJ. Sample size for individually matched case-control studies. Biometrics 1986; 42(4):919-26.
  22. Al-Fartosi KG. The association between ABO blood group and spontaneous abortion. basrah journal of science 2008; 26(1B english):1-10.
  23. A Basic Guide to Blood Groups Author: Jeff Daniels - Translated by: Jahangir Abdi.
  24. Shahverdi E, Moghaddam M, Talebian A, Abolghasemi H. Distribution of blood groups in the Iranian general population. J Blood Group Serol Mol Genet 2016; 32(4):135.
  25. Hosseini MM, Baniaghil SS, Balkhi MR, Seyedein MS. Frequency distribution of blood groups ABO and Rh in the population of blood donors in Golestan province during 2006-2010. Scientific Journal of Iran Blood Transfus Organ 2012; 9(3):358-62.
  26. Pourfathollah AA, Oody A, Honarkaran N. Geographical distribution of ABO and Rh (D) blood groups among Iranian blood donors in the year 1361 (1982) as compared with that of the year 1380 (2001). Scientific Journal of Iran Blood Transfus Organ 2004; 1(1):11-7.
  27. Khalid Gata Washeel Al-Fartosi. The ASSOCIATION BETWEEN ABO BLOOD GROUP AND SPONTANEOUS ABORTION. Basrah Journal of Scienec (B(Vol.26(1),1-10, 2008
  28. Pereira N, Patel HH, Stone LD, Christos PJ, Elias RT, Spandorfer SD, et al. Association between ABO blood type and live-birth outcomes in single-embryo transfer cycles. Fertil Steril 2017; 108(5):791-797.
  29. Higgins JR, Walshe JJ, Darling MR, Norris L, Bonnar J. Hemostasis in the uteroplacental and peripheral circulations in normotensive and pre-eclamptic pregnancies. Am J Obstet Gynecol 1998; 179(2):520-6.
  30. Nejat EJ, Jindal S, Berger D, Buyuk E, Lalioti M, Pal L. Implications of blood type for ovarian reserve. Hum Reprod 2011; 26(9):2513-7.
  31. Melzer D, Perry JR, Hernandez D, Corsi AM, Stevens K, Rafferty I, et al. A genome-wide association study identifies protein quantitative trait loci (pQTLs). PLoS Genet 2008; 4(5):e1000072.
  32. Paré G, Chasman DI, Kellogg M, Zee RY, Rifai N, Badola S, et al. Novel association of ABO histo-blood group antigen with soluble ICAM-1: results of a genome-wide association study of 6,578 women. PLoS Genet 2008; 4(7):e1000118.
  33. Alikani M. Epithelial cadherin distribution in abnormal human pre-implantation embryos. Hum Reprod 2005; 20(12):3369-75.
  34. Shih IeM, Hsu MY, Oldt RJ, Herlyn M, Gearhart JD, Kurman RJ. The role of E-cadherin in the motility and invasion of implantation site intermediate trophoblast. Placenta 2002; 23(10):706-15.
  35. Staun-Ram E, Shalev E. Human trophoblast function during the implantation process. Reprod Biol Endocrinol 2005; 3(1):56.
  36. Goldsammler M, Jindal SK, Kallen A, Mmbaga N, Pal L. Blood type predicts live birth in the infertile population. J Assist Reprod Genet 2015; 32:551-5.
  37. Mu L, Jin W, Yang H, Chen X, Pan J, Lin J, et al. ABO blood type is associated with ovarian reserve in Chinese women with subfertility. Oncotarget 2016; 7(32):50908.
  38. Lin S, Li R, Chi H, Huang S, Zhang H, Zheng X, et al. Effect of ABO blood type on ovarian reserve in Chinese women. Fertility and sterility. 2014; 102(6):1729-32.
  39. Torabizadeh A, Fazelifar S. Evaluation of the relationship between blood group and RH with pregnancy and delivery problems in 3,000 mothers referring in two health Care centers in mashhad. Iran J Obstet Gynecol Infertil 2001; 4(9-10):60-65.
  40. Abdollahi E, Tavasolian F, Ghasemi N, Vakili M, Amini A. The effect of parental ABO blood group on fetal surveillance. Iran J Ped Hematol Oncol 2013; 3(4):154-8.
  41. Omu AE, Al-Mutawa M, Al-Qattan F. ABO blood group and expression of antisperm antibodies in infertile couples in Kuwait. Gynecol Obstet Invest 1998; 45(1):49-53.
  42. Ogbimi AO, Oyeyinka GO, Omu AE. ABO blood group incompatibility and infertility in Nigerian couples. Immunol Lett 1987; 14(4):299–301.
  43. Schwimmer WB, Ustay KA, Behrman SJ. An evaluation of immunologic factors of infertility. Fertil Steril 1967; 18(2):167-80.
  44. Behrman SJ, Buettner-Janusch J, Heglar R, Gershowitz H, Tew WL. ABO (H) blood incompatibility as a cause of infertility: a new concept. Am J Obstet Gynecol 1960; 79:847-55.
  45. Lauritsen JG, Jøorgensen J, Kissmeyer-Nielsen F. Significance of HLA and blood-group incompatibility in spontaneous abortion. Clin Genet 1976; 9(6):575-82.