Haemolytic disease of the newborn due to maternal irregular antibodies in the Chinese population in Taiwan

Abstract

From 1991 to 2000, amongst 23,886 full-term healthy Chinese babies delivered at our hospital, 2615 babies developed neonatal hyperbilirubinaemia. After excluding other causes of hyperbilirubinaemia and identifying the irregular antibodies, 15 cases of haemolytic disease of the newborn (HDN) due to maternal irregular antibodies were diagnosed; three cases were born in our hospital and 12 cases were referred. Amongst these 15 babies, six cases had HDN due to anti-E, three cases due to anti-E + c, three cases due to anti-D, one case due to anti-c and two cases due to 'Mi' antibodies reacting with MiIII phenotype cells (anti-Hil and anti-Mur). Although there were four cases of hydrops fetalis, only one of the patients expired. The prevalence of HDN caused by maternal irregular antibodies has been estimated to be 0.01%. Therefore, routine prenatal screening for irregular antibodies was not rational in the Chinese population in Taiwan. Anti-E and anti-E + c were the important irregular antibodies resulting in HDN. Although few cases of HDN due to anti-'Mi' have been reported, Anti-'Mi' is significant in regions with a high prevalence of the MiIII phenotype.

Abo/Rh Distribution Pattern and Prevalence of Irregular Antibodies in Healthy Blood Donors of Uttarakhand

“…20 Britain. 21 21 22 Sallander et al 23 Bojadzieva et al 24 Makroo et al 25 Myhre et al 26 Richard et al 27 Winters et al 28 Giblett et al 29 Tormey et al 30 Zhu et al 31 Yeela et al 32 Garcia et al 33 Andersen et al 34 Wu et al 35 Varghese et al 36 Jeremiah et al 37 Healthy …”

A Newborn Case of “c” Subgroup Mismatch Presenting with Severe Hemolysis and Anemia

“…In some countries, despite the low frequency, non-anti-D-erythrocyte alloimmunisation screening is recommended for gestation because of severe hemolytic disease due to subgroup incompatibility whereas in some others, these screenings are not recommended (13,14). In our country, anti-D administration in pregnancy for Rh incompatibility is adopted as a health policy but screening for subgroup incompatibility in pregnancy is not on the agenda yet (15).…”

Reticulocytosis: the unevaluated parameter in neonatal jaundice requiring phototherapy

“…16 Similar results were obtained by Sgro et al 2,17 Other than Rh and ABO incompatibility, moderate to severe cases of neonatal jaundice attributed to other minor group antibodies has been described in Asian population in the last ten years. 18,19 Genetic studies and screening of mother for irregular antibodies were not done in the study, due to financial constraints. Further genetic studies should also be considered, in those cases where no identifiable etiology are found.…”