Serological profile and hemolytic disease in term neonates with ABO incompatibility
Keywords:
ABO incompatibility, hyperbilirubinemia, DAT
Abstract
Background Hemolytic disease of the newborn (HDN) due toABO 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.
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clinical significance of blood group incompatibility in mothers
with blood type A or B. J Pediatr. 1994;125:87-91.
22. Cantayuda B. Inkompatibilitas ABO di rumah sakit Tjipto
Mangunkusumo (RSTM) Jakarta [Thesis]. Jakarta: Faculty
of Medicine University oflndonesia; 1980.
23. Desjardins L, Blajchman MA, Chintu C. The spectrum of
ABO hemolytic disease of the newborn infant. J Pediatr.
1979;95:44 7-9.
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editors .. An introduction to immunohematology. 2nd ed.
Philadelphia: WB Saunders Co, 1982; p. 195-206.
25. Maissels MJ. Neonatal jaundice. 2008 [cited 2008 April 2].
Available from: http://pedsinreview.aappublications.org
readmission. Pediatrics. 1998;101:995-8.
2. Lee K-S, Perlman M, Ballantyne M. Association between
duration of neonatal hospital stay and readmission rate. J
Pediatr. 1995;127:758-66.
3. Soskolne EL, Schumaker R, Fyock C, Young ML, Schorck
A. The effect of early discharge and other factors on
readmission rates of newborns. Arch Pediatr Adolesc Med.
1996;150:373-9.
4. Liu LL, Clemens CJ, Shay DK, Davis RL, Novack AH. The
safety of newborn early discharge: the Washington State
experience. JAMA. 1997;278:293-8.
5. Porter ML, Dennis BL. Hyperbilirubinemia in term newborn.
Am Fam Phys. 2002;65:599-614.
6. Oski FA, Naiman JL. Erythroblastosis fetalis. In: Oski FA,
NaimanJL, eds. Hematologic problems in the newborn. 2nd
ed. Philadelphia: Saunders, 1982; p.l77 -235.
7. Nathan DG, Oski FA. ABO hemolytic disease. In: Nathan
DG, Oski FA, editors. Hematology of the infancy and
childhood. 4th ed. Philadelphia: Saunders, 1993; p. 495-
674.
8. Seidman DS. Predicting the risk of jaundice in full-term
healthy newborns: a prospective population-based study. J
Perinatal. 1999;19:564-7.
9. Iskandar W. Prevalens dan risiko hemolisis bayi dengan
inkompatibilitas ABO yang lahir di RSUP Dr. Hasan Sadikin
Bandung [Thesis]. Bandung: Faculty of Medicine Padjadjaran
University; 2002.
10. Stoll BJ, Kliegman RM. Blood disorder. In: Behrman RE,
Kliegman RM, Jensen HB, editors .. Nelson textbook of
pediatrics. 17th ed. Philadelphia: WB Saunders Co, 2004;
p. 592-9.
11. Gomella TL. Blood abnormalities. In: Gomella TL,
Cunningham MD, Eyal FG, Zenk KE, editors. Neonatology
management, procedures, on-call problems, disease and drugs.
5th ed. Connecticut: Appleton & Lange, 2004; p. 332-53.
12. Cunningham FG, Gant NF. ABO blood group system. In:
Cunningham FG, Gant NF, Gilstrap L, HauthJC, Wenstrom
KD, Leveno KJ, editors .. Williams obstetrics. 21st ed. New
York: Me Graw Hill, 2001; p. 1058-9.
13. Mentzer WC, Glader EB. Erythrocyte disorders in infancy. In:
Taeusch HW, Ballard RA, editors. Disease of the newborn.
7th ed. Philadelphia: WB Saunders Co,l998; p. 1080-118.
14. Wagle S, Deshpande PG. Hemolityc disease of newborn. 2004
[cited on 2004 November 22]. Available from: http://www.
emedicine.com
15. Katz MA, Kanto WP, Korotkin JH. Recurrence rate of
ABO hemolytic disease of the newborn. Obstet Gynecol.
1982;59:611-4.
16. Kadri N. Beberapa faktor risiko terjadinya ikterus neonatal
pada kehamilan inkompatibel ABO. MKI. 1998;48:332-8.
17. Sarici SU, Yurdakok M, Serdar MA, Oran 0, Erdem G,
Tekinalp G, et al. An early (sixth-hour) serum bilirubin
measurement is useful in predicting the development of
significant hyperbilirubinemia and severe ABO hemolytic
disease in selective high risk population of newborns with
ABO incompatibility. Pediatrics. 2002;109:e53.
18. de Alarcon PA, Werner EJ. Normal values and laboratory
methods. In: de Alarcon PA, Werner EJ, eds. Neonatal
Hematology.lst ed. Cambridge University Press, 2005; p.
406-30.
19. Brouwers HAA, Ertbruggen IV, Alsbach GPJ, Overbeeke
MAM, Schaasberg W, Heiden CVD, et al. What is the best
predictor of the severity of ABO-haemolytic disease of the
newborn? Lancet. 1988;2:641-4.
20. Quinn MW, Weindling AM, Davidson DC. Does ABO
incompatibility matter? Arch Dis in Chi!. 1988;63:1258-
60.
21. Ozolek ZA, Watchko JF, Mimouni F. Prevalence and lack of
clinical significance of blood group incompatibility in mothers
with blood type A or B. J Pediatr. 1994;125:87-91.
22. Cantayuda B. Inkompatibilitas ABO di rumah sakit Tjipto
Mangunkusumo (RSTM) Jakarta [Thesis]. Jakarta: Faculty
of Medicine University oflndonesia; 1980.
23. Desjardins L, Blajchman MA, Chintu C. The spectrum of
ABO hemolytic disease of the newborn infant. J Pediatr.
1979;95:44 7-9.
24. Bryant NJ. Hemolytic disease of the newborn. In: Bryan NJ,
editors .. An introduction to immunohematology. 2nd ed.
Philadelphia: WB Saunders Co, 1982; p. 195-206.
25. Maissels MJ. Neonatal jaundice. 2008 [cited 2008 April 2].
Available from: http://pedsinreview.aappublications.org
Published
2009-08-31
How to Cite
1.
Dharmayani D, Gatot D, Rohsiswatmo R, Tridjaja B. Serological profile and hemolytic disease in term neonates with ABO incompatibility. PI [Internet]. 31Aug.2009 [cited 24Dec.2024];49(4):219-3. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/560
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Received 2016-09-10
Accepted 2016-09-10
Published 2009-08-31
Accepted 2016-09-10
Published 2009-08-31
