Knowledge and Attitude of Pregnant Women on ABO and Rhesus Blood Grouping Towards Preventing Neonatal Hemolytic Disease at Rasheed Shekoni Federal University Teaching Hospital, Dutse, Jigawa State, Nigeria
Main Article Content
Keywords
ABO Blood Group, Rhesus Factor , Hemolytic Disease of the Newborn, Pregnant women, Antenatal Care , Dutse , Jigawa State, Northern Nigeria, Nigeria
Abstract
Background: Hemolytic Disease of the Fetus and Newborn (HDFN) is a significant neonatal condition resulting from ABO and Rhesus (Rh) blood group incompatibility between mother and fetus. Adequate knowledge and positive attitudes among pregnant women toward blood grouping can help prevent complications. This study assessed the Knowledge and Attitude of Pregnant Women on ABO and Rhesus Grouping towards Preventing Neonatal Hemolytic Disease at Rasheed Shekoni Federal University Teaching Hospital, Dutse, Jigawa state.
Methodology: A descriptive cross-sectional study was conducted among 316 pregnant women receiving antenatal care at the hospital. A structured questionnaire was used to collect data on socio-demographic characteristics, knowledge of ABO and Rh blood grouping, and attitude toward their importance in preventing HDFN. Data were analyzed using descriptive and inferential statistics.
Results: The majorities of respondents (46.2%) were aged 26–30 years and most had at least a secondary education (57.2%). Awareness of ABO and Rh blood groups was high, with 70.3% of respondents knowing their blood group and Rh status. However, only 16.5% demonstrated good knowledge of HDFN, while 33.2% had poor knowledge. Awareness of preventive measures, including the anti-D immunoglobulin, was low (17.4%). Despite knowledge gaps, attitudes were positive, with 87.7% recognizing the importance of blood grouping in pregnancy, and 98.4% supporting public health campaigns on the topic. Age (p = 0.001), educational level (p = 0.001), occupation (p = 0.001), family income (p = 0.001) and number of pregnancies (p = 0.003) were significantly associated with knowledge levels. Attitude was also significantly associated with age (p = 0.003), educational level (p = 0.003) and family income (p = 0.024).
Conclusion: While awareness of blood grouping was high, knowledge of HDFN and its preventive measures remained limited. Strengthening antenatal education and implementing targeted awareness programs are essential to improve understanding and ensure the effective prevention of HDFN.
References
2. American College of Obstetricians and Gynecologists. ACOG Practice Bulletin No. 192: Management of alloimmunization during pregnancy. Obstetrics and gynecology. 2018 Mar;131(3):e82-e90.
3. De Nazaré Gonçalves E Silva J, De Souza AM, Rosario FMD, Pinto LC. Pregnant women’s knowledge and clinical management of hemolytic disease of the fetus and newborn in Pará, Brazil. Hematology Transfusion and Cell Therapy [Internet]. 2024 May 25;46:S201–7. Available from: https://doi.org/10.1016/j.htct.2024.03.007
4. Li S, He Z, Luo Y, Ji Y, Luo G, and Fang G. Distribution of maternal red cell antibodies and the risk of severe alloimmune haemolytic disease of the foetus in a Chinese population: a cohort study on prenatal management. BMC Pregnancy Childbirth. 2020;20:2–11. https://doi.org/10.1186/s12884-020- 03235-w
5. Slootweg YM, Walg C, Koelewijn JM, Van Kamp IL, De Haas M. Knowledge, attitude and practices of obstetric care providers towards maternal red‐blood‐cell immunization during pregnancy. Vox Sanguinis [Internet]. 2019 Dec 29;115(3):211–20. Available from: https://doi.org/10.1111/vox.12883
6. Practice Bulletin No. 181: Prevention of Rh D Alloimmunization. Obstet Gynecol. 2017 Aug;130(2):e57-e70. [PubMed] [Reference list]
7. Kemper AR, Newman TB, Slaughter JL, Maisels MJ, Watchko JF, Downs SM, et al. Clinical Practice Guideline revision: Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. PEDIATRICS [Internet]. 2022 Aug 5;150(3). Available from: https://doi.org/10.1542/peds.2022-058859
8. de Winter DP, Kaminski A, Tjoa ML, Oepkes D. Hemolytic disease of the fetus and newborn: systematic literature review of the antenatal landscape. BMC Pregnancy and Childbirth. 2023 Jan 7;23(1):12.
9 Hall V, Vadakekut ES, Avulakunta ID. Hemolytic disease of the fetus and newborn. InStatPearls [Internet] 2025 Jan 22. StatPearls Publishing.
10 Naiman JL, de Alarcon PA. On Dr. Louis K. Diamond's 1932 article and subsequent contributions to erythroblastosis fetalis. Journal of pediatric hematology/oncology. 2001 Aug 1;23(6):373-6.
11 Gabbay JM, Agneta EM, Turkington S, Bajaj BM, Sinha B, Geha T. Rates of phototherapy among ABO-incompatible newborns with a negative direct antiglobulin test. Journal of Perinatology. 2023 Nov;43(11):1357-62.
12 Yu D, Ling LE, Krumme AA, Tjoa ML, Moise Jr KJ. Live birth prevalence of hemolytic disease of the fetus and newborn in the United States from 1996 to 2010. AJOG Global Reports. 2023 May 1;3(2):100203
13 Okeke, N., and Anya, C. Addressing knowledge gaps in ABO and Rh compatibility: Strategies for better maternal and fetal outcomes. Nigerian Journal of Public Health. 2021; 22(3), 175-183
14 Abdullahi UI. Neonatal morbidity and mortality in a rural tertiary hospital in Nigeria. CHRISMED Journal of Health and Research. 2018 Jan 1;5(1):8-10.
15 Umeora, O., Obuna, J., and Onoh, R. Prevalence and determinants of hemolytic disease in Nigerian neonates. African Medical Journal. 2019; 44(7), 290-295
16 Okon, A., Asuquo, O., and Udo, I. Patterns of neonatal admissions and mortality due to HDFN. Nigerian Journal of Neonatology. 2020; 10(2), 55-63
17 Yusuf, K., Abdulrahman, I., and Saleh, B. Maternal knowledge of Rh factor and implications for neonatal health in northern Nigeria. BMC Pregnancy and Childbirth. 2021; 21(10), 376-384.
18 Adamu, L., and Bello, K. Awareness of blood group compatibility among pregnant women attending antenatal care in northern Nigeria. Journal of Maternal Health Studies. 2019; 12(4), 233-239
19 Yamane T. Statistics: an introductory analysis. 2nd ed. New York, NY: Harper and Row; 1967.
20 Okafor, P., Adekunle, S., and Lawal, J. (2019). Utilization of antenatal care services and awareness of Rh incompatibility in Nigeria. International Journal of Maternal Health, 7(1), 90-102.
21 Adebayo, A., and Salisu, T. Maternal awareness and willingness to undergo blood grouping: A cross-sectional study. Journal of Maternal Health Studies.2022; 12(3), 45-56.
22 Ibrahim, M., Yusuf, H., and Bello, T. The impact of maternal health education on Rh incompatibility awareness. Journal of Public Health and Education. 2021; 9(2), 78-89.
23 Adeyemi, O., Adebayo, T., and Olufemi, A. (2020). Knowledge of blood grouping across different age categories in Lagos, Nigeria. West African Medical Journal, 37(4), 145-156
24 Okafor, C., Eze, M., and Nwosu, P. (2021). The role of education in shaping attitudes toward maternal health interventions in Abuja. Nigerian Journal of Medical Research, 19(2), 150- 168
25 Tesfaye, S., Teshome, T., and Kiros, H. (2019). Knowledge and awareness of ABO and Rh blood group screening among pregnant women in Addis Ababa, Ethiopia. Ethiopian Journal of Health Sciences, 29(6), 905-911.
26 Adeyemo, R., Ibrahim, L., and Odetola, M. (2021). The impact of socioeconomic factors on health literacy in Ibadan, Nigeria. Nigerian Journal of Health Education, 14(2), 78-92
27 Kumar, P., Yadav, A., and Kumar, S. (2020). Knowledge and awareness of Rh incompatibility and ABO blood group screening in preventing hemolytic disease of the newborn: A study in India. Indian Journal of Obstetrics and Gynecology, 70(1), 45-52.
28 Okeke, N., and Anya, C. (2021). Addressing knowledge gaps in ABO and Rh compatibility: Strategies for better maternal and fetal outcomes. Nigerian Journal of Public Health, 22(3), 175-183
29 Mohammed, S., and Ahmed, H. Parity and maternal health knowledge in Sudanese women. Sudanese Journal of Reproductive Health. 2019; 8(2), 112-125
30 Nwafor, C., Eze, J., and Obinna, F. Pregnancy complications and knowledge of blood grouping in Port Harcourt, Nigeria. Nigerian Journal of Obstetrics and Gynecology. 2020; 17(1), 67-81
31 Kamau, P., and Mwangi, J. Health awareness among tertiary-educated rural Kenyan women. East African Health Review. 2018; 15(2), 56-69.
32 Nwosu CO, Ataguba JE. Socioeconomic inequalities in maternal health service utilisation: a case of antenatal care in Nigeria using a decomposition approach. BMC public health. 2019 Dec;19:1-1.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.