Objective of the study is to research the epidemiological aspects of maternal alloimmunization against erythrocyte antigens of fetuses (AB0, Rhesus, Lewis, Kell, Duffy and others) and to identify the most common types of hemolytic disease of the newborn (HDN) in the West Herzegovina region. Study Design The 20-year retrospective epidemiological study includes all pregnant women who had been immunologically tested and newborn treated for HDN. Results The indirect antiglobulin (IAT) detected antibodies against antigens in 545 (1.8%) pregnant women of the 29 663 who were tested at the Department of Transfusion Medicine. During the 20-year-long study 310 (1.0%) newborn with HDN were treated. Our results indicate that 42% (230/545) of the pregnant women had AB0 immunization. The most common form of HDN is AB0 HDN 64% (199/310), whereas RhD HDN was treated in 19% (59/310) of the newborn infants. ETR was performed on 29 (19%) infants, 21 (72.4%) with AB0 HDN, and 7 (26%) with RhD HDN. Conclusion This 20-year-long study concludes that, even though there has been significant progress in the prevention of immunization and proactive treatment of HDN, precautionary measures are still required as is the need for gynecologists and obstetricians to be active. The reasons for this are the non-existence of preventive measures for non-RhD immunization, the irregular immunological screening of RhD positive women in pregnancy in the region encompassed by the study in the past few years. The above raises new questions and recommends further research and monitoring of immunization and HDN treatment worldwide.
ABSTR AC T IntroductionThe objective of the analysis was to examine the epidemiological aspects of maternal alloimmunization and to determine the most common antibody specificities resulting in hemolytic disease of the newborn (HDN). Materials and MethodsThe retrospective epidemiological study encompasses all pregnant women who underwent immunohematological screening and the newborn treated for HDN in the period from 2000 to 2013 in the Herzegovina region. ResultsThe indirect Coombs test (ICT) detected antibodies against antigens in 384 (2.4 %) pregnant women of the 18 800 who were tested at the Department of Transfusion Medicine. The direct Coombs test (DCT) detected antibodies against antigens in 160 (0.8 %) newborn treated for HDN. The results of our 13-year study, in which 60 % of the pregnant women had non-RhD antibodies, confirms this finding.Conclusion However, we have reached the 21st century and the burden of alloimmunisation in pregnancy is still on our backs. The problem of immunization and HDN is still present in our region, which is a neonatal and public health problem.
The aim of this research is to analyze the characteristics of children immunized during immunization season, and their readmission to hospital due to infections of the respiratory tract in the period from 2008 to 2016. The retrospective cohort study included 101 children. The test group consists of infants who met the strict criteria for immunization. The national guidance was determined on the basis of earlier research and recommendations by the AAP. All the children who had been readmitted for hospitalization were quickly tested for RSV. Of this total, 47 children were preterm children (46.5%), 43 (42.5%) were children with CHD, and 11 (11%) exhibited other individual risk factors (gestational age 33-34 weeks, neurological disorders, respiratory anomalies, multi-organ anomalies). 25 (24%) patients of the immunized study population readmitted the ward due to respiratory infections. Of these, 50% were under the age of 6 months and were treated for less than a week on average. Upon readmission, a quick test to diagnose for RSV infections was conducted, which was negative for all of the previously immunized children. Palivizumab represents an effective prevention to avoid RSV infections, that significantly contributes to mortality for children at risk, especially in developing countries.
The aim of the study is to determine the effect of body mass index in pregnancy on the CRP concentration in pregnant women and their newborn. The results of the study will serve as a guide for a more valid assessment of slightly elevated concentrations of CRP and a potential new guide for the treatment of newborns with antibiotics. The research is a cohort prospective study of 2 groups of pregnant women and their newborn with respect to the body mass index of the pregnant women prior to delivery. The study included 128 pregnant women and their newborn whose serum was analysed to ascertain CRP concentration. The CRP concentration in pregnant women with an elevated BMI was higher than in the pregnant women with normal BMI during pregnancy. The difference is statistically significant (p<0.001). The CRP concentration taken from the umbilical cord and during the second day of life of the newborn of the pregnant women with an elevated BMI was statistically significantly higher than in the newborn of the pregnant women with normal BMI during pregnancy (p<0.001). A repeated blood test conducted between the third and fifth day of life showed that the concentration of CRP in the newborn of both study groups was within referential values. The study indicates a significant correlation between BMI in pregnancy and CRP concentration in pregnant women and their newborn. The results of this study are a potential milepost in addressing the dilemma of whether to administer antibiotics to newborns with elevated CRP values (<20 mg/L) without aggravating their clinical condition. It may be necessary to simply repeat the laboratory tests of CRP in the blood of the newborn in the first days of life and thus follow its dynamics.
Objective Cystatin C (Cys-C) concentration has not been examined sufficiently among healthy newborn population, particularly in terms of reference values. This study aimed to establish gender-, postnatal age- and birth weight-specific Cys-C concentration for healthy term newborns. Its objective was also to examine if there were any differences between our measured concentration and the reference interval established by the CALIPER study. Methods Serum samples from a total of 90 healthy term newborns were used to determine Cys-C concentration. Cys-C was measured within first three days of birth using particle-enhanced turbidimetric immunoassay (PETIA) on the Architect plus ci8200 analyzer. Results Median concentration of the Cys-C was 2.05 mg/L. There were no statistically significant differences in Cys-C concentration regarding gender (p=0.779), birth weight (p=0.505), postnatal age (p=0.512) or Apgar score (p=0.799). The value of the 2.5th and 97.5th percentile for Cys-C concentrations for girls was 0.93–3.15 mg/L and for boys it was 1.5–3.36 mg/L. Conclusion Cys-C concentration in healthy term newborns does not depend on gender, birth weight, postnatal age, or Apgar score. Our measured concentration range of CyS-C in healthy newborns turned out to be slightly wider than the interval determined in the CALIPER study.
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