Frequency of ABO Incompatibility in Neonates as Cause of Neonatal Jaundice  admitted in a Neonatal Unit of Tertiary Care Hospital

Abstract

Objective: To determine the frequency of maternal-fetal ABO incompatibility in newborns with neonatal jaundice. Study Design: Cross-sectional study. Place and Duration of Study: Neonatal Intensive Care Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan from Apr 2020 to Jan 2021. Methodology: All full-term newborns of either gender presenting with neonatal jaundice and need of phototherapy were consecutively enrolled. ABO blood incompatibility in neonatal jaundice was labelled as positive based on the presence of increased levels of serum indirect bilirubin in a newborn with blood group type A or B and maternal blood group type O. Information was collected regarding gender, birth weight, duration of hospital stay, hemoglobin level on admission, hematocrit level, indirect bilirubin level, direct Coombs test, duration of phototherapy, and need for intravenous immunoglobulin therapy. Results: Of 225 neonates, the mean birth weight was 3283.12±1116.11 grams. The ABO incompatibility was observed in 37(16.4%) infants. The findings of multivariable analysis revealed that, after adjusting for other covariates, the odds of ABO incompatibility was 3.28 times higher among neonates with hemolysis as compared to the neonates without hemolysis (aOR 3.28, 95% CI 1.42-7.71). Similarly, after adjusting for other covariates, the odds of ABO incompatibility was 3.53 times higher among neonates with >50 hours of phototherapy duration as compared to neonates with ≤50 hours of phototherapy duration (aOR 3.53, 95% CI 1.40-8.89). Conclusion: In conclusion, 16.4% newborns with neonatal jaundice were ABO incompatible. Moreover, hemolysis and longer phototherapy requirement were considerably higher in these neonates than those who were not ABO incompatible.

Keywords

• ABO incompatibility, Blood group system, Indirect bilirubin, Jaundice