Newborn Screening for ABO Hemolytic Disease

Levine, David H.; Meyer, Heike

doi:10.1177/000992288502400707

Cited by 22 publications

(14 citation statements)

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“…37 Levine and Meyer opined that confusion existed regarding the true incidence of ABO-HDFN, because of the ambiguity in the significance of various laboratory investigations commonly employed for its evaluation. 38 This could be the reason for disparity of results in previous studies and our study.…”

Section: Discussioncontrasting

confidence: 74%

Frequency of Antibodies in Haemolytic Disease of Foetus and Newborn

Vilambil¹,

Dharmadas²,

Usha³

et al. 2017

jemds

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BACKGROUNDHaemolytic disease of foetus and newborn (HDFN) is triggered by enhanced destruction of red blood cell due to immune-mediated destruction, intrinsic abnormalities, acquired aberrations, etc. Lifespan of infant's erythrocytes are shortened by the action of placentally transferred maternal antibodies in immune-mediated HDFN.The aim of this study was to identify the frequency of maternal antibodies in neonates with hyperbilirubinaemia. Settings and Design-This was a cross-sectional study in neonates admitted to neonatal intensive care unit (NICU). Setting for the research was Dept. of Transfusion Medicine and Neonatology division of Sree Avittom Thirunal Hospital for women and children attached to Govt. Medical College, Trivandrum.

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Section: Discussioncontrasting

confidence: 74%

Frequency of Antibodies in Haemolytic Disease of Foetus and Newborn

Vilambil¹,

Dharmadas²,

Usha³

et al. 2017

jemds

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“…1 Diagnostic applicability of DAT in ABO HDFN has a wide range of controversies. According to Levine et al and Schonitzer et al DAT was neither a tool for diagnosis nor a predictor of severity of disease, while it was found to be beneficial for establishing ABO HDFN by Bel et al, Dufour et al and Whyte et al 24,25,5,26,27 Dinesh had postulated that in infants with clinically significant haemolysis, 80% had a positive DAT. 28 While Bjarte and Morten opined that antepartum and postpartum serologic tests were poor predictors of ABO haemolytic disease, Umit et al suggested that reticulocyte count, a positive DAT and the presence of a sibling with neonatal jaundice were good predictors for the development of significant hyperbilirubinaemia and severe haemolytic disease.…”

Section: Discussionmentioning

confidence: 99%

“…26 David et al and Quinn et al observed that DAT was neither diagnostic nor predictive of severity in ABO HDFN. 27,20 Density of A and B antigens in cord red cells was studied using an immuno-enzymatic assay and no statistically significant association was found between antigen maturity and severity of ABO HDFN.…”

Section: Discussionmentioning

confidence: 99%

Immunohaematological Profile of Maternal Antibody-Mediated Abo Haemolytic Disease of Foetus and Newborn

Vilambil¹,

Dharmadas²,

Usha³

et al. 2017

jemds

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BACKGROUNDThe potency of anti-A and anti-B was determined by racial and environmental factors. With respect to ethnic groups, the prevalence and intensity of maternal-newborn ABO incompatibility varied in different populations. The aim of this study is to describe the immunological profile of ABO HDFN. Settings and Design-This was a descriptive study conducted in neonates with ABO HDFN. Research was conducted in Depts. of Transfusion Medicine and Neonatology division of Paediatrics in Govt. Medical College, Trivandrum. MATERIALS AND METHODSThose neonates who fulfilled the inclusion criteria were enrolled in this study. Demographic details, maternal details, bilirubin and haemoglobin levels were recorded. Investigations such as maternal blood grouping and antibody titration were done. In infant's blood sample direct antiglobulin test, blood grouping and elution was performed.Statistical Analysis-All statistical data were analysed using SPSS software version 16. RESULTSAmong mothers of infants with ABO HDFN 25 (22.7%) had a titre of 128, 34 (30.9%) had 256, 35 (31.8%) had 512 and 16 (14.6%) had 1024. Among 110 infants 34 (30.9%) were DAT positive, while the rest 76 (69.1%) were DAT negative. While DAT positive was graded 13 (11.8%) fell in grade 1, 16 (14.6%) in grade 2, 3 (2.7%) in grade 3 and 2 (1.8%) in grade 4 categories. Eluate from 59 (53.6%) of infants with ABO HDFN gave a positive result, while the rest 51 (46.4%) gave a negative result. Out of that 59 (53.6%) elution positive infants, 34 (30.9%) had a positive DAT and 25 (22.7%) had a negative DAT; 51 (46.4%) of infants were negative for both elution and DAT. CONCLUSIONMothers of infants with ABO HDFN had an antibody titre of 128 -1024. Almost one-third of infants were DAT positive and majority fell in grade 1 or 2. Eluate from half of infants gave a positive result.

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“…Clinical course and severity of subsequent hyperbilirubinaemia or isommune disease is diffi cult to predict in a newborn with ABO incompa bility because there is no single test that is of high predic ve value 15,16 .…”

Section: Discussionmentioning

confidence: 99%

Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility

Arora

Shifali

2016

J. Nepal Paedtr. Soc.

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Introduction: Neonatal hyperbilirubinaemia is common problem which is benign in majority of neonates. Rh iso immune hemolytic disease as a cause of hyperbilirubinemia is becoming nearly nonexistent due to the use of prophylactic anti D. Hence Isoimmune hemolytic disease due to ABO incompatibility assumes significance as a cause of significant hyperbilirubinaemia. This study was conducted to determine the incidence of ABO incompatibility, ABO iso immune disease in new born, to determine critical cord serum bilirubin level to predict subsequent significant hyperbilirubinemia. Material and Methods: The study was done in neonatal ICU of a tertiary care hospital where 100 full term healthy newborns with B.W≥2500gm and gestational age ≥37 wk with blood group A, B, AB, born to mothers with O blood group without simultaneous Rh incompatibility at SGRDIMSR were included. Serum bilirubin was measured approximately at 12-24hrs, 36-48hrs, 60-72hrs. Results: Out 100 ABO incompatible newborns 33(33%) developed ABO isoimmune disease manifesting as significant hyperbilirubinaemia with any of the four total serum bilirubin levels exceeding threshold levels defined for phototherapy. TSB of ≥ 2.16mg/d1 from cord blood has a sensitivity of 100% specificity of 89.55%, NPV 100% and PPV of 82.50% to predict significant hyperbilirubinaemia. Conclusion: A critical cord S.bilirubin between 2.16 mg/d1 and 4.09mg/d1 will predict all newborns who will have significant hyperbilirubinaemia and can be used as a safe demarcator to decide time of discharge. Any therapeutic intervention if necessary can be started as early as possible.

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Newborn Screening for ABO Hemolytic Disease

Cited by 22 publications

References 7 publications

Frequency of Antibodies in Haemolytic Disease of Foetus and Newborn

Frequency of Antibodies in Haemolytic Disease of Foetus and Newborn

Immunohaematological Profile of Maternal Antibody-Mediated Abo Haemolytic Disease of Foetus and Newborn

Cord Serum Bilirubin Level in Predicting the Development of Significant Hyperbilirubinemia in Newborns with ABO Incompatibility

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