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Effects of maternal serum IgG anti-A (B) and neonatal direct anti globulin red blood cell antibody expression on the occurrence and development of neonatal ABO haemolysis

Objectives: To explore the expression of maternal serum IgG anti-A (B) and neonatal direct anti globulin, free antibody and Red Blood Cell (RBC) antibody on the occurrence and development of ABO Haemolytic Disease of the New-born (ABO-HDN) and provide a valuable reference for the early diagnosis of the disease.

Methods: we selected 546 cases of jaundice and hyperbilirubinemia neonates in our hospital from February 2013 to February 2016, tested the maternal serum IgG anti-A (B) titer, neonatal direct anti globulin, free antibody and RBC antibody, calculated the prevalence ratio of ABO haemolytic disease and analysed the effects of these indexes in the occurrence and development of ABO-HDN.

Results: Among 546 cases, 227 cases were diagnosed as ABO haemolytic disease, the prevalence ratio being 41.6%. The prevalence rate of ABO haemolytic disease of group A and group B were not statistically significant (P>0.05). Pearson correlation analysis showed that there was a positive correlation of pregnant women's serum IgG anti-A (B) titer and neonatal ABO haemolytic rate (r=0.883, P<0.01). The serum IgG anti-A (B) titer level of pregnant women was not significantly correlated with the severity of the disease. The difference was not statistically significant (P>0.05). Among all the 227 patients with ABO haemolytic disease, the positive rate of RBC antibody testing was 100.0%, which is higher than that of the free antibody testing 74.9%. The difference was statistically significant (P<0.05) and the positive rate of free antibody testing was also higher than that of direct anti globulin testing 14.9%. The difference was statistically significant (P<0.05).

Conclusion: The combined detection of pregnant women's serum IgG anti-A (B) and neonatal erythrocyte antibody expression is expected to provide evidence for the clinical early diagnosis of ABOHDN. At the same time, with the increase of the titer of pregnant women's serum IgG anti-A (B), risks of ABO-HDN will gradually increase, which should be paid more attention.

Author(s): Ming Chen, Yu Zeng, Xiaohe Chen