Relationship of blood types and ABO hemolytic disease of the newborn / 中国新生儿科杂志

Objective:To compare the differences of hemolysis between OA and OB blood type in ABO hemolytic disease of the newborn (ABO-HDN), to study the clinical features of ABO hemolytic disease in different type.Methods:From January 2015 to June 2020, full-term ABO-HDN neonates born to blood type O mothers admitted to our hospital were enrolled in this retrospective study. The neonates were assigned into OA group and OB group. SPSS 25.0 software were used to analyze the clinical data.Results:A total of 755 cases were enrolled, including 364 cases of OA group and 391 cases of OB group. On hour-specific bilirubin nomogram, no significant differences existed in high intermediate risk zone between the two groups ( P>0.05). In the low risk zone and the low intermediate risk zone, the proportion of newborns in OA group was higher than the OB group ( P<0.05). In the high risk zone, the proportion of newborns in the OB group was higher than the OA group ( P<0.05). The age of admission of the OB group was younger than the OA group ( P<0.05). The incidences of immunoglobulin usage and blood transfusion in the OB group were higher than the OA group ( P<0.05). No significant differences existed between the two groups in Coombs? test, antibody elution test, free antibody test, platelet count, reticulocyte percentage, the onset time of jaundice, the median serum total bilirubin level, the average hemoglobin level and the incidence of anemia on admission ( P>0.05). No significant differences existed in the incidence of exchange transfusion, the duration of phototherapy and hospitalization between the two groups ( P>0.05). Conclusions:Compared with OA incompatibility, newborns with OB incompatibility have higher incidences of hyperbilirubinemia, blood transfusion and younger age of admission. However, the two groups have similar rate of exchange transfusion and phototherapy and hospitalization duration.

Blood group serological testings of ABO hemolytic disease of newborn: A retrospective analysis / 中国输血杂志

【Objective】 To retrospectively analyze blood samples of suspected hemolytic disease of newborn(HDN)mothers and infants, and detect hemolytic disease caused by irregular antibodies, so as to provide help for the clinical diagnosis and treatment of HDN. 【Methods】 632 suspected HDN samples from Obstetrics and Pediatrics Department of our hospital from January 2016 to October 2018 were collected, and serologically detected by microcolumn gel technique, as well as DAT, free antibody test and antibody release test. 【Results】 Among 632 samples, 306 were HDN positive, with a positive rate at 48.4%, 64 suspected HDN, accounting for 10.1%, and 262 non confirmed HDN, accounting for 41.5%. 180 samples were type A, among which 145 were HDN positive, with a positive rate at 80.56%; 233 were type B, among which 157 were HDN positive, wiht a positive rate at 67.38%; 210 were type O, among which 1 was HDN positive, with a positive rate at 0.48%; 9 were type AB, among which 3 were HDN positive, with a positive rate at 33.33%. The positive rates of HDN differed by blood types (P<0.05). In 632 suspected HDN samples, 9 were with irregular antibody + immune anti-A, and 136 with solo immune anti-A; 10 were with irregular antibody + immune anti-B, and 170 with solo immune anti-B; 1 was with irregular antibody + immune anti-A and anti-B, and 2 with immune anti-A and anti-B; 4 HDN cases were caused by irregular antibody, while anti-S and anti-E cconstituted 2 and 2 cases, respectively. 【Conclusion】 ABO HDN is more common and attracts more attention in clinical practice than HDN scaused by other group systems, which were rare and easy to be ignored, but also may cause moderate and severe HDN. even severe anemia, edema and stillbirth of fetus. Therefore, it is necessary to carry out irregular antibody screening during pregnancy so as to achieve early detection and treatment.

Fetomaternal hemorrhage in RhD-negative pregnant women in Tianjin / 国际生物医学工程杂志

Objective To study and monitor the situation of femomaternal hemorrhage (FMH) in RhD-negative pregnant women in Tianjin, obtain the FMH data of such population, and analyze the relationship between FMH and age, blood type, gestational age, hemolytic disease of postpartum neonates, etc. Methods The FMH level was detected by flow cytometry with FITC-anti-HbF monoclonal antibody. The blood type was detected by blood serum method. The irregular antibody was identified by saline method and indirect anti-human ball method. The hemolysis of postpartum neonates was detected by three tests of hemolysis. Results The FMH volume of 86 RhD negative pregnant women was between 0 and 11.48 ml, with an average of 1.82 ml. There were 63.95％of pregnant women showed a volume of FMH<2.0 ml, 23.26％between 2 and 4 ml, 11.63％between 4.0 and 10.0 ml, and 1.16％>10 ml. The proportion of lower FMH in pregnant women≤30 years old was>11.71％higher than that in the pregnant women>30 years old, but the difference was no statistical significant. There was no significant difference in FMH of pregnant women with O, A, B and AB types. The proportion of higher FMH in pregnant women with compatible ABO blood type with her husband was 12.46％ lower than that of the heterozygous cases, but the difference was no statistical significant. The proportion of higher FMH in the pregnant women with 28 to 32 weeks gestational age was 14.55％ higher than that of ≤28 weeks and was 35.32％ higher than that of >32 weeks, and the differences were statistical significant. Three samples in the 86 samples were positive for anti-D antibody, and their three hemolytic test results were strongly positive with the anti-D titer from 1:2 to 1:32 and the FMH volume from 1.50 to 6.93 ml. The proportion of lower FMH in the 10 pregnant women without postpartum hemolysis was 70％ higher than that in 5 pregnant women with postpartum hemolysis, but the differences were not statistical significant. Conclusions The results suggest that monitoring FMH content by flow cytometry can reflect FMH in Rh-negative pregnant women. The studies on the relationship between FMH and age, blood type, pregnant time and hemolytic disease of postpartum neonates can provide basically experimental data for standard use of anti-D immunoglobulin in pregnant women.

Analysis of anti-A (B) IgG antibody titer in 3 463 pregnant women with blood type O / 临床检验杂志

Objective To investigate the threshold of IgG anti-A (B) antibody with microcolumn gel method and analyze the correlations between the incidence of neonatal hemolytic disease and IgG antibody titer in pregnant women as well as their age for the guidance of prenatal early prevention.Methods Based on blood type of 3 463 perinatal pregnant women and their husbands,the titers of prenatal antibody IgG against A and B were determined by both microcolumn gel and test tube method.The 1 620 pregnant women with blood type O were divided into three groups according to different pregnancy times (1,2,3 or more than 3 times).The titers of serum IgG anti A and B were determined every 4 weeks from the 22th week using micro column gel method.The newborn hemolytic disease-related indicators were detected simultaneously.Results In this laboratory,256 of the antibody titer by microcolumn gel method was used as the indoor reference value.The geometric average titer of IgG anti-A was 169 in 2 257 person-times of perinatal women,and the titer of IgG anti-B was 143 in 1 711 person-times of perinatal women.The 1 620 women with blood type O were continuous monitored at different pregnant times.In 896 women with first pregnancy,260 cases (29.02％)showed 256 or more than 256 of IgG anti A (B)antibody titer,107 cases (43.15％) in 248 women with the second pregnancy showed 256 or more of IgG anti A (B) antibody titer,and 220 cases (46.70％) in 476 women with the third pregnancy or more showed 256 or more of IgG anti A (B) antibody titer.The average ages of the pregnant women with increased 1,2 and 3 antibody titers were 26.4,27.8 and 29.9 respectively,and the incidences of hemolytic disease of newborn (HDN) were 21.66％,40.94％ and 84.90％ respectively.Conclusion In detecting IgG antibody in prenatal serum of pregnant women with O type,the sensitivity of microcolumn gel method for IgG antibody should be obviously higher than that of the traditional test tube method.The reference value of microcolumn gel method or IgG antibody titer was obviously higher than that of test tube method.The positive rate of IgG anti-A antibody in multiple pregnancies was significantly higher than that in the first pregnancy.The incidence of HDN may increase with the age of pregnant women when the titer of IgG antibody increased by 2 or more titers.

The clinical application of prenatal serum blood group IgG antibody titer determination / 国际检验医学杂志

Objective To assess the relationship between the serum IgG antibody titer of pregnant women and the hemolytic dis‐ease of newborn(HDN) .Methods Using microcolumn gel coombs card assay method to determine titer of 255 cases of couples an‐tenatal serum IgG antibody and ABO blood group .Results with 195 cases of ABO‐incompatible couples ,the positive rate of abnor‐mal serum IgG antibody(≥64)was 93 .8% .The titer of anti‐A/B IgG :in 12(6 .2% ) cases was <64;in 12(6 .2% )cases was 64;in 60(30 .8% )cases was 128 ;in 39(20% )cases was 256 ;in 45(23 .0% )cases was 512 ;in 27(13 .8% ) cases was 1 024 .There were no statistical differences between IgG anti‐A(B) titers distribution between A/O blood group matching and B/O blood group matching (χ2 =4 .361 ,P=0 .499) ,IgG anti‐A( B) titers was higher in AB/O blood group matching .Conclusion we can take early and effec‐tive prevention ,treatment ,reducing the incidence of HDN by the determination of prenatal serum IgG antibody titers in ABO‐in‐compatible couples ,which is important for the population of eugenics .

Hemolytic Disease of the Newborn Caused by Anti-M in 2 Male Siblings / 대한주산의학회잡지

Hemolytic disease of the newborn (HDN) caused by anti-M is rare and clinical manifestations are variable ranging from mild anemia and hyperbilirubinemia to hydrops fetalis and intrauterine fetal death. There were few reports of HDN caused by anti-M in Korea but no case in siblings. We experienced a case of 2 male siblings, both of whom had anti-M induced HDN and prolonged anemia persisted for over a month. We report this case with a brief review of literature. This report documents the first case of HDN caused by anti-M in siblings in Korea.

Application of microcolumn gel technology in detection of neonatal hemolytic disease / 国际检验医学杂志

Objective To investigate the application value of microcolumn gel technology in screening hemolytic disease of the newborns(HDN) .Methods The direct antiglobulin test(DAT) ,antibody release test and free antibody test were performed in 212 cases of suspected HDN in our hospital by using microcolumn gel assay .Results In 212 cases of suspected HDN ,50 cases(23 .6% ) were diagnosed as HDN ,including 45 cases (21 .2% ) of ABO‐HDN and 5 cases (2 .4% ) of Rh‐HDN .In 45 cases of ABO‐HDN ,23 cases (36 .5% ) were A blood type and 22 cases (28 .2% ) were B blood type .The sensitivity of antibody release test ,DAT and free antibody test was 100% ,28% and 92% respectively .Conclusion The microcolumn gel technology can detect HDN fastly and accu‐rately ,with the advantages of simple operation ,less sample consumption ,high sensitivity and specificity ,which can provide reliable basis for HDN diagnosis and is worth popularizing and applying in clinic .

Analysis of blood group serology results in 276 cases of neonatal jaundice / 国际检验医学杂志

Objective To understand the incidence of hemolytic disease in newborn (HDN)among the newborns with jaundice and the coincidence degree of the blood group serological results and the clinical diagnosis in HDN.Methods The microcolumn gel method was adopted to detect the 3 serological indexes in 276 jaundice newborns of maternal fetal blood group incompatibility,in-cluding the direct antiglobulin test,free antibody test and antibody release test.Results 108 cases of HDN were clinically diagnosed with the positive rate of 39.13%.The positive detection rate in newborns with 0-2 d old was highest(50.00%).Conclusion The serological test can provide the basis for the early diagnosis and treatment of HDN.Collecting the specimen as early as possible can improve the positive diagnosis rate of HDN.

A Case of Hemolytic Disease of Newborn due to Anti-JKa / 대한주산의학회잡지

The Kidd system of blood group is clinically significant since the anti-Kidd antibody can cause immediate or delayed hemolytic transfusion reactions as well as hemolytic disease of newborn (HDN). In contrast to the hemolytic activity of Kidd antibodies in incompatible transfusion, the severity of HDN varies but usually tends to be a benign clinical course with favorable outcomes. And severe HDN due to anti-JKa incompatibility is a rare, which is still not reported in Korea. We experienced a newborn with severe jaundice to be detected within 24 hours from birth due to anti-JKa incompatibility. The laboratory data on admission indicated hemoglobin 13.2 g/dL, reticulocyte 4.08%, total bilirubin 18.7 mg/dL, and direct and indirect antiglobulin tests were positive (2+/2+). But, there are no ABO and Rh (D) incompatibilities between the mother and newborn. Maternal serum was found to contain an antibody that recognized JKa , and also seen in neonate. This patient completely recovered with intensive phototherapy without exchange transfusion. We report this case with a brief review of relevant literature.

A Case of Hemolytic Disease of Newborn due to Anti-JKa / 대한주산의학회잡지

The Kidd system of blood group is clinically significant since the anti-Kidd antibody can cause immediate or delayed hemolytic transfusion reactions as well as hemolytic disease of newborn (HDN). In contrast to the hemolytic activity of Kidd antibodies in incompatible transfusion, the severity of HDN varies but usually tends to be a benign clinical course with favorable outcomes. And severe HDN due to anti-JKa incompatibility is a rare, which is still not reported in Korea. We experienced a newborn with severe jaundice to be detected within 24 hours from birth due to anti-JKa incompatibility. The laboratory data on admission indicated hemoglobin 13.2 g/dL, reticulocyte 4.08%, total bilirubin 18.7 mg/dL, and direct and indirect antiglobulin tests were positive (2+/2+). But, there are no ABO and Rh (D) incompatibilities between the mother and newborn. Maternal serum was found to contain an antibody that recognized JKa , and also seen in neonate. This patient completely recovered with intensive phototherapy without exchange transfusion. We report this case with a brief review of relevant literature.

Utilidad de la prueba directa de Coombs en el tamiz neonatal / Usefulness of direct antiglobulin test in neonatal screening

Introducción. La ictericia es un evento clínico frecuente que se presenta en los recién nacidos; las causas más frecuentes involucradas en la enfermedad hemolítica del recién nacido (EHRN) continúan siendo la incompatibilidad al sistema ABO y la isoinmunización a RhD. La prueba directa de Coombs (PDC) permite identificar la presencia de anticuerpos antieritrocitarios del isotipo IgG, provenientes del suero materno en la superficie de los eritrocitos del feto o neonato. Objetivo: presentar los resultados y especificidad de la prueba directa de Coombs (PDC) como prueba en el tamiz neonatal. Métodos. Consecutivamente se incluyeron a recién nacidos no seleccionados. En las primeras horas de vida se determinó el grupo sanguíneo ABO/RhD y la PDC con suero poliespecífico y monoespecíficos (anti-IgG y C3b/C3d). Resultados. Se incluyeron 5 007 recién nacidos, la PDC positiva se documentó en 181 neonatos (3.6%). Los casos del grupo sanguíneo A, B o AB, mostraron mayor riesgo de tener PDC positiva que los del grupo O (razón de momios 2.3, intervalo de confianza 95% 1.7-3.1). La PDC positiva se presentó en 3.5% de los neonatos RhD positivo y en 1.9% de los RhD negativo; 72.9% de los neonatos con PDC positiva tuvieron titulaciones de 1:2, 1 ;4 y 1:8, con el 33.1, 19.9 y 19.9%, respectivamente. En los neonatos con PDC positiva se pudo establecer el isotipo anti-IgG en 117 casos (64.6%), complemento sólo en 6 casos (3.3%), la combinación de ambas en 6 casos (3.3%) y en 52 neonatos (28.8%), con PDC poliespecífico positivo, no se pudo identificar la especificidad de la reacción. Conclusión. La prevalencia elevada (3.6 %) de PDC positiva en la detección neonatal rutinaria, apoya la indicación de incorporar dicha prueba al tamiz neonatal, independientemente del grupo ABO y Rh materno. Queda por establecer su beneficio en la detección temprana de la ictericia neonatal.

Background. Neonatal jaundice is a clinical event frequently present in newborns. The causes most frequently involved in hemolytic disease of newborn (HDN) are still the incompatibilities to the ABO/Rh blood system. Direct Coombs test (or direct antiglobulin test, DAT) allows identification of the presence of red blood cell antibodies (IgG isotype) coming from the maternal serum on the surface of the fetus erythrocytes. The purpose of this study is to show the results and specificity of DAT as screening in newborn infants. Methods. We studied unselected neonates in a cross-sectional design. During the early hours of life, we determined ABO/Rh and DAT with poly- and monospecific reagents (anti-IgG and C3b/C3d). Results. We included 5 007 newborns; 181 cases (3.6%) were DAT positive. Newborns with A, B or AB blood groups showed an increased association of being DAT positive than group O (OR 2.3, 95% Cl 1.7-3.1). DAT was positive in 3.5% of RhD-positive infants and 1.9% of RhD-negative infants. In six DAT-positive cases, 117 cases (64.6%) had anti-IgG bound to red cell membrane, complement in six cases (3.3%), and 52 newborns (28.8%) were polyspecific DAT positive and monospecific DAT negative. Conclusions. The high prevalence (3.6%) of DAT-positive cases in routine neonatal detection supports the indication to incorporate DAT into neonatal screening, regardless of the mother's blood group. The benefit of early intervention in neonatal jaundice remains to be established.

Relationship between the valence of antibody in pregnant women with blood type O in serum and hemolytic disease of newborn / 中国基层医药

Objective To study the reLationship between blood group antibody IgG titer of pregnant women and ABe hemolytic disease of newborn(HDN).Methods Blood group antibody IgG titem of 2700 pregnant women who is O and Rh positive with a non-O husband were detected.After bom,blood groups,Coomb's test,free antibody and antibody release test were done for those 280 babies who were in high risk of HDN.so that we could understand the relationship between the anlibody IgG level of pregnant women and ABO-HDN.Results The percent of anti-A (B)IgG titer＜64,64,128,256 and≥512 in the 2700 O type pregnant women was 62.4%,16.8%,12.6%,5.8%and 2.4%,respectively.There were 67 babies suffered from HDN in those 280 bahies who had high risk.which accounted for 23.9%.With the anti-A (B)IgG liter was 64,128,256 and≥512,the percent of HND positive was 10.2%,27.8%,45.7% and 50.0%,respectively (P＜0.01).Conclusion There is a positive relationship between blood group antibody IgG liter of pregnant women and ABO-HDN.It is necessary for the pregnant women to detect the level of anti-A(B)IgG.

A Case of Neonatal Jaundice due to Anti-Jk(b) / 대한주산의학회잡지

The Kidd (Jk) system is one of the most important blood group systems in transfusion medicine due to immediate or delayed hemolytic transfusion reactions as well as hemolytic disease of newborn (HDN). We experienced a case of jaundice and hemolytic anemia in a newborn due to anti-Jk(b) incompatibility appearing within the first 24 hours of life. The infant's direct and indirect antiglobulin tests were positive. There were no ABO and Rh (D) incompatibilities between the mother and the baby. Direct Coomb's IgG was strongly positive but C3d was negative. We started the exchange transfusion with the whole blood and had a favorable outcome. We report this case with a brief review of relevant literature.

A Case of Hemolytic Disease in a Newborn Due to Anti-Jk(b)

The isoimmune hemolytic disease of newborn due to the incompatibility of minor blood groups is characterized by progressive neonatal hyperbilirubinemia and anemia caused by the IgG antibody transmitted from the mother to the fetus. Recently we had a case of hemolytic disease in a newborn due to anti-Jk(b). There were no ABO and Rh(D) incompatibilities between mother and baby. The infant's direct and indirect antiglobulin tests were strongly positive. From the mother and baby, an irregular antibody was found and identified as anti-Jkb. Generally, hemolytic disease of the newborn resulting from anti-Jkb incompatibility has a benign clinical course and a good prognosis. This patient completely recovered without exchange transfusion. We report this case with a brief review of relevant literature.

Relationship between ABO hemolytic disease of newborn and maternal antibody / 第三军医大学学报

Objective To study the relationship between ABO hemolytic disease of newborn and maternal antibody. Methods The titer of blood group antibody in 122 mothers of O blood group during prenatal diagnosis and blood group serology, bilirubin and hemoglobin level of newborn infants were tested with routine methods. The relationship between ABO hemolytic disease of newborn and the titer of blood group antibody was studied. Results The titer of blood group antibody was remarkably related with ABO hemolytic disease of newborn (P

A Case of Hemolytic Disease of the Newborn in Identical Twin due to Anti-c antibody / 대한소아혈액종양학회지

Anti-c is an important Rh antibody that causes hemolytic disease of the newborn. Recently we had a case of hemolytic disease of the newborn in identical twin due to anti-c. The five-day-old female twin were admitted at our hospital due to jaundice. There were no ABO and Rh (D) incompatibilities between mother and babies. The newborn's direct and indirect antiglobulin tests were positive and the maternal serum showed a positive antibody screening test. The laboratory findings warranted hemolytic disease of newborn due to other Rh antibodies. The specificity of unexpected antibodies were anti-c in maternal serum and fetal serums. The babies were treated with only phototherapy for 10 days and discharged in recovery.

A Case of Hemolyic Disease of Newborn Caused by Anti-c and Anti-E Antibody / 대한주산의학회잡지

Hemolytic disease of newborn due to Rhesus incompatibility occurs mostly by anti-Rh(D) antibodies. But recently, because of Rh(D) immune globuin prophylaxis, Rh(D) incompatibility is decreased and importance of minor group incompatibility is increasing. The majority of minor blood group incompatibilities are anti-c, anti-E or anti-Kell, but hemolytic diseases caused by combination of these antibodies are relatively rare. The 21 day-old male neonate was admitted because of pallor and poor feeding for 2 days. Laboratory data showed severe normochromic and normocytic anemia with increased reticulocyte and bilirubin. Patient's and his mothers blood type was B, Rh(D) positive. Minor blood groups of mother's and sons were different and anti-c and anti-E antibody were detected in mother's serum. After transfusions of two times with anti-c and anti-E free B, Rh(D) positive blood, the baby was discharged at 11th hospital day with good general condition.

Irregular Antibody Screening in Cord Blood by Column Agglutination Test / 대한수혈학회지

BACKGROUND: Irregular antibodies are antibodies that are not regularly present in the serum of particular blood groups and its presence results in many problems including HDN (hemolytic disease of newborn) in transfusion medicine. Column agglutination test was recently introduced and has been widely used for advantages of standardized working procedures, standard reactions, stable reactions for hours and Coombs test without washing steps. We tested irregular antibodies in cord blood by column agglutination test and investigated its incidence and relation with HDN. METHODS: We tested the cord blood collected during delivery from 200 pregnant women. Column agglutination test was done on DiaMed ID MicroTyping System (DiaMed, Switzerland) and both LISS/Coombs and NaCl/Enzyme ID-cards were used. The antibody screening test was done first and antibody identification test was done to positive cases in same way. The cell typing and Rh phenotyping for cord blood of positive cases were also done. RESULTS: 2 cases of 200 samples (1%) were positive in the antibody screening test and each was identified as anti-D and anti-E antibody. CONCLUSIONS: Irregular antibody screening in cord blood by column agglutination test is thought to be helpful in early diagnosis and treatment of HDN.

The relationship between the IgG anti-body titers, the concentration of IgG subclasses of group O pregnant women and ABO hemolytic disease of newborn / 中国输血杂志

Objective To study the relationship between the IgG antibody titer, the concentration of IgG subclasses in group O maternal sera and hemolytic disease of newborn. Methods By means of blood group serology assay, IgG antibody titers in 317 pregnant women who had incompatible blood group with their husbands was measured. The concentration of IgG subclasses were measured in HDN infants and their mothers, healthy pregnant women and healthy infants by ELISA. Results 1) Among 317 maternal sera, 153 cases (48.3%) were found to have IgG antibody titers higher than 1∶64, with anti-A and anti-B in 89 and 64 cases, respectively. Seventy-one (22.4%) newborns suffered from ABO-HDN, with 46 anti-A and 25 anti-B; 2) With increased numbers of pregnancy, the proportions women with greater than 1∶64 IgG antibody increased, and there was significant difference between those with one pregnancy and those with more than one pregnancies; 3) The levels of IgG antibody in HDN infants and their mothers were higher than those in control group, and IgG1 was the predominant subclass. Meanwhile, the proportion of IgG1 in infants was higher than in pregnant women. Conclusion To some couples of ABO incompatibility, IgG antibody titer and IgG subclasses should be tested in pregnant women. The incidence of HDN increases with increased antibody titers. The severity of HDN correlates positively with the concentration of IgG1 in maternal sera.