Serological profile and hemolytic disease in term neonates with ABO incompatibility

Abstract

Background Hemolytic disease of the newborn (HDN) due to ABO blood type incompatibility is one of the most common cause of neonatal hyperbilirubunemia that potentially leads to bilirubin encephalopathy. Data on ABO-hemolytic disease of the newborn (ABO-HDN), especially regarding umbilical cord blood serological profile, are limited. Objective To identify the serological profile and hemolytic disease in term neonates with ABO incompatibility. Methods This was a cross-sectional descriptive study, conducted at RSIA Budi Kemuliaan Jakarta. Results We found 68 healthy term neonates with ABO incompatibility, nine of them had positive direct antiglobulin test (OAT) result, and 38 subjects had a positive result on OAT with elution method. The highest titer of IgG was 1:8. Hyperbilirubinemia was found in 30 ( 44%) subjects, and ABO-HDN was diagnosed in 28 (41 %) subjects. Within the positive OAT group, eight out of nine subjects had suffered from hyperbilirubinemia and ABO-HDN. Meanwhile, within the positive OAT with elution method group; 24 subjects had suffered from hyperbilirubinemia with 23 of them having ABOHDN. Based on the chi-square analysis; those with positive OAT with elution method had 3.2 times higher risk of suffering from ABO-HDN. Furthermore, there was a 3.6 times higher risk of sufferring from hyperbilirubinemia. Conclusion In healthy term neonates with ABO incompatibility, the incidence of ABO-HDN is 41%. OAT serological examination with elution method is better than OAT in assessing risk for hyperbilirubinemia and ABO-HDN.

Keywords

• ABO incompatibility
• hyperbilirubinemia
• DAT