Original ArticleHemolysis and Hyperbilirubinemia in Antiglobulin Positive, Direct ABO Blood Group Heterospecific Neonates
Section snippets
Methods
The study was approved by the institutional review board of the Shaare Zedek Medical Center. Because of the benign nature of the study, which did not involve randomization or administration of a study drug, oral parental consent only was required. The clinical wing of the study was conducted in the well-infant nurseries of the Shaare Zedek Medical Center from January 2006 to April 2007. A sample of consecutive (except for the conditions mentioned below) infants who were DAT-positive with blood
Results
One hundred sixty-four newborns who were DAT positive with blood group A or B born to blood group O mothers were enrolled between January 2006 and April 2007 (Table I). Overall, a PTB value >95th percentile for hour-of-life at any point 85 developed in newborns (51.8%). Age at first PTB >95th percentile was 19 ± 11 hours (range, 1-48 hours; one additional newborn was re-admitted at age 80 hours), with corresponding PTB 9.9 ± 2.5 mg/dL (range, 5.1-17.8 mg/dL). Early hyperbilirubinemia (PTB >95th
Discussion
Of the neonatal population delivered at the Shaare Zedek Medical Center, 21% comprise blood group A or B newborns born to group O mothers, and 15% of them are DAT positive.16 In this study, we documented a 52% incidence of hyperbilirubinemia in the DAT-positive subgroup. This incidence is clearly many-fold that of other population groups studied with the identical definition of hyperbilirubinemia. For example, in a multicenter, multinational study of 1370 newborns, hyperbilirubinemia developed
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Cited by (51)
Neonatal hemolytic disease: How should we use indirect and direct antiglobulin tests?
2024, Pediatrics and NeonatologyIs it necessary to add the eluate testing to the direct antiglobulin test to improve the detection of maternal erythrocyte alloantibodies?
2021, Transfusion and Apheresis ScienceCitation Excerpt :The primary cause of maternal erythrocyte alloimmunization in the present study was the ABO fetal-maternal incompatibility (79.6 %) similar to that reported in the literature [25,26]. Therefore, in agreement with previous reports [11,27–29], the present study evidenced the importance of screening for ABO alloantibodies in type A and type B neonates of type O mothers and not only by the DAT test but also the eluate testing. Additionally, the finding of irregular alloantibodies apart from anti-RhD (13.6 %), anti-RhC (2.3 %), and anti-Fya (2.3 %) were also detected emphasizing the need to include the IAT in the prenatal follow-up independent of the RhD phenotype of the mother.
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