Retrospective analysis of HDFN due to ABO incompatibility in a single institution over 6 years.
ABO incompatibility
ABO red cell antigens
DAT
haemolytic disease of fetus and newborn
immune anti-A/anti-B IgG antibodies
Journal
Transfusion medicine (Oxford, England)
ISSN: 1365-3148
Titre abrégé: Transfus Med
Pays: England
ID NLM: 9301182
Informations de publication
Date de publication:
Jun 2019
Jun 2019
Historique:
received:
27
08
2017
accepted:
31
12
2017
pubmed:
26
1
2018
medline:
26
12
2019
entrez:
26
1
2018
Statut:
ppublish
Résumé
To study the rate of ABO haemolytic anaemia of fetus and newborn (HDFN) in one institution over 6 years. ABO major incompatibility between mothers and their newborns occurs in about 10% of births. So, mothers with an O blood group may form IgG-class antibodies against A and B antigens, which could pass across the placenta and lead to a variable degree of HDFN in the newborn. At our institution, we have reviewed data regarding ABO-based HDFN in the last 6 years. We found that, in 28 089 deliveries, an ABO major incompatibility between mothers and newborns occurs in 11% of cases, with 72% of O/A and 28% of O/B incompatibility. In turn, 23% of these newborns had an eluate-confirmed positive direct antiglobulin test [DAT; 74% (511) were due to anti-A and 26% (179) to anti-B], with 1·0% requiring invasive treatments (exchange transfusion or intravenous immunoglobulin). Overall, 2·5% of the total newborns had a positive DAT for an anti-A or anti-B antibody, and 0·11% required invasive treatment in addition to phototherapy for their HDFN. Serological ABO HDFN is a relatively frequent event when an O-A/O-B incompatibility between mothers and their newborn occurs and, in most cases, translates into a self-limiting disease, with a small number of newborns requiring invasive treatments. The DAT test, although not predictive of disease severity, appears to be a useful tool to monitor babies born from O-A/O-B-incompatible pregnancies and to identify those who may require treatment.
Sections du résumé
OBJECTIVES
OBJECTIVE
To study the rate of ABO haemolytic anaemia of fetus and newborn (HDFN) in one institution over 6 years.
BACKGROUND
BACKGROUND
ABO major incompatibility between mothers and their newborns occurs in about 10% of births. So, mothers with an O blood group may form IgG-class antibodies against A and B antigens, which could pass across the placenta and lead to a variable degree of HDFN in the newborn.
METHODS
METHODS
At our institution, we have reviewed data regarding ABO-based HDFN in the last 6 years.
RESULTS
RESULTS
We found that, in 28 089 deliveries, an ABO major incompatibility between mothers and newborns occurs in 11% of cases, with 72% of O/A and 28% of O/B incompatibility. In turn, 23% of these newborns had an eluate-confirmed positive direct antiglobulin test [DAT; 74% (511) were due to anti-A and 26% (179) to anti-B], with 1·0% requiring invasive treatments (exchange transfusion or intravenous immunoglobulin). Overall, 2·5% of the total newborns had a positive DAT for an anti-A or anti-B antibody, and 0·11% required invasive treatment in addition to phototherapy for their HDFN.
CONCLUSIONS
CONCLUSIONS
Serological ABO HDFN is a relatively frequent event when an O-A/O-B incompatibility between mothers and their newborn occurs and, in most cases, translates into a self-limiting disease, with a small number of newborns requiring invasive treatments. The DAT test, although not predictive of disease severity, appears to be a useful tool to monitor babies born from O-A/O-B-incompatible pregnancies and to identify those who may require treatment.
Substances chimiques
ABO Blood-Group System
0
Isoantibodies
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
197-201Subventions
Organisme : Ortho Clinical Diagnostics
Informations de copyright
© 2018 British Blood Transfusion Society.