大约 15% 的白人血型为 RhD 阴性。[4]Mourant AE, Kopec AC, Domaniewska-Sobczak K. The distribution of the human blood groups and other biochemical polymorphisms. 2nd ed. London: Oxford University Press; 1976. 人群数据显示,巴斯克人中 RhD 阴性的比例最高 (36%)。[4]Mourant AE, Kopec AC, Domaniewska-Sobczak K. The distribution of the human blood groups and other biochemical polymorphisms. 2nd ed. London: Oxford University Press; 1976. 7% 的黑人属于这种血型。[4]Mourant AE, Kopec AC, Domaniewska-Sobczak K. The distribution of the human blood groups and other biochemical polymorphisms. 2nd ed. London: Oxford University Press; 1976. 美洲原住民和亚洲人群中不到 1% 有这种表型。[4]Mourant AE, Kopec AC, Domaniewska-Sobczak K. The distribution of the human blood groups and other biochemical polymorphisms. 2nd ed. London: Oxford University Press; 1976. 由于最近 40 年来,免疫预防已经成为常规诊疗实践,RhD 导致的 Rh 同种异体免疫发生已显著下降。[5]Joseph KS, Kramer MS. The decline in Rh hemolytic disease: should Rh prophylaxis get all the credit? Am J Public Health. 1998 Feb;88(2):209-15.https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.88.2.209http://www.ncbi.nlm.nih.gov/pubmed/9491009?tool=bestpractice.com[6]Van der Schoot CE, Soussan AA, Koelewijn J, et al. Non-invasive antenatal RHD typing. Transfus Clin Biol. 2006 Mar-Apr;13(1-2):53-7.http://www.ncbi.nlm.nih.gov/pubmed/16564727?tool=bestpractice.com 生育延迟和家庭规模缩小等社会因素也可能是引起发病率下降的原因。[5]Joseph KS, Kramer MS. The decline in Rh hemolytic disease: should Rh prophylaxis get all the credit? Am J Public Health. 1998 Feb;88(2):209-15.https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.88.2.209http://www.ncbi.nlm.nih.gov/pubmed/9491009?tool=bestpractice.com
在英国,大约 16% 的白人为 RhD 阴性。 据估计,在 2005 年,英国的 RhD 阴性妇女大约产下 65,000 例 RhD 阳性婴儿(占所有出生婴儿的 10%)。[7]National Institute for Health and Care Excellence. Routine antenatal anti-D prophylaxis for women who are rhesus D negative. Aug 2008 [internet publication].https://www.nice.org.uk/guidance/ta156
美国疾病控制与预防中心报告,1991 年 Rh 溶血性疾病在活婴的发生率为 1/1000 例。 2003 年的数据显示,发病率为 6.8/1000 例活婴。 这一不一致很可能是由于对易患妇女的识别和报告增加,以及可用的非典型、非 RhD 抗体患病率升高,而这些患者并没有有效的免疫预防措施。[8]Chavez GF, Mulinare J, Edmonds LD. Epidemiology of Rh hemolytic disease of the newborn in the United States. JAMA. 1991 Jun 26;265(24):3270-4.http://www.ncbi.nlm.nih.gov/pubmed/1904504?tool=bestpractice.com[9]Martin JA, Hamilton BE, Sutton PD, et al. Births: final data for 2003. Natl Vital Stat Rep. 2005 Sep 8;54(2):1-116.https://www.cdc.gov/nchs/data/nvsr/nvsr54/nvsr54_02.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/16176060?tool=bestpractice.com 关于其中几种抗体的相对发生率已有相关报告。[8]Chavez GF, Mulinare J, Edmonds LD. Epidemiology of Rh hemolytic disease of the newborn in the United States. JAMA. 1991 Jun 26;265(24):3270-4.http://www.ncbi.nlm.nih.gov/pubmed/1904504?tool=bestpractice.com 在一个包括超过 300,000 例连续病例入选的大型前瞻性系列研究中发现,大约 1% 的妊娠妇女在妊娠早期检测到同种异体抗体。[10]Koelewijn JM, Vrijkotte TG, van der Schoot CE, et al. Effect of screening for red cell antibodies, other than anti-D, to detect hemolytic disease of the fetus and newborn: a population study in the Netherlands. Transfusion. 2008 May;48(5):941-52.http://www.ncbi.nlm.nih.gov/pubmed/18248570?tool=bestpractice.com 其中,抗 D 之外其他同种抗体的患病率是 328/100,000,其中 191/100,000 有发生胎儿和新生儿溶血性疾病的风险,这是因为父亲携带抗原。 最常见的非抗 D 抗体是抗 K 和抗 c 抗体。[10]Koelewijn JM, Vrijkotte TG, van der Schoot CE, et al. Effect of screening for red cell antibodies, other than anti-D, to detect hemolytic disease of the fetus and newborn: a population study in the Netherlands. Transfusion. 2008 May;48(5):941-52.http://www.ncbi.nlm.nih.gov/pubmed/18248570?tool=bestpractice.com