Abstract

Background Hemolytic disease of the newborn (HDN) due to ABObo 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 ABObo incompatibility.
Methods This was a cross-sectional descriptive study, conducted at RrSIA Bbudi Kemuliaan Jakarta.
Results We found 68 healthy term neonates with ABO incompatibility, nine of them had positive direct antiglobulin test (DAT) result, and 38 subjects had a positive result on DAT 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 DAT group, eight out of nine subjects had suffered from hyperbilirubinemia and ABO-HDN. Meanwhile, within the positive DAT with elution method group; 24 subjects had suffered from hyperbilirubinemia with 23 of them having ABO-HDN. Based on the chi-square analysis; those with positive DAT 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 ABObo incompatibility, the incidence of ABO-HDN is 41%. DAT serological examination with elution method is better than DAT in assessing risk for hyperbilirubinemia and ABO-HDN. [Paediatr Indones. 2009;49:219-23].

Keywords: ABO incompatibility, hyperbilirubinemia, DAT