Clinical Analysis On 91 ABO Incompatibility Hemolytic Disease Of Newborns

Objective:To know about the incidence, clinical features, blood type distribution and serological characteristics of ABO incompatibility hemolytic disease of newborns. The purpose of the study is to provide some clinical references on early diagnosis and early prevention and treatment for newborns with ABO incompatibility hemolytic disease. Methods:This is a retrospective study. We collected all the cases admitted to two hospitals (First Hospital of Shanxi Medical University and Children's Hospital of Shanxi Province) from February the 1st 2009 to December 31st of 2009, which were both meeting the criteria of neonatal ABO incompatibility hemolytic disease and inclusion criteria described in detail in material and methods part. Firstly, a total of 91 newborns were divided into 2 groups according to blood type. Group A (n=43) were A-blood type. Group B (n=48) were B-blood type. Differences between the two groups in gestational age, birth weight, first time of jaundice appearance, the peaking time of total serum bilirubin (TSB), peak of the total serum bilirubin (TSB) and the incidence of anemia were analyzed. And differences between the two groups in terms of the positive incidence of direct antiglobulin test and free antibody test were also analyzed. Secondly, all results of antibody release test were positive after admission. A total of 91 newborns were divided into 2 groups based on the result of direct antiglobulin test. Group 1 (n=32) were direct antiglobulin test positive. Group 2 (n=59) were direct antiglobulin test negative. Differences between the two groups in gestational age, birth weight, first time of jaundice appearance, the peaking time of the total serum bilirubin (TSB), peak of the total serum bilirubin and the incidence of anemia were analyzed. Results:There were no statistical significant differences between A-blood type and B-blood type of newborns in terms of gestational age, birth weight, first time of jaundice appearance, the peaking time of the total serum bilirubin (TSB), peak of the total serum bilirubin and the incidence of anemia (P>0.05). There were no statistical significant differences between direct antiglobulin test positive and negative newborns in terms of gestational age, birth weight, the peak of the total serum bilirubin (P>0.05). Totally 27 cases were direct antiglobulin test positive (84.4%) and 35 cases were direct antiglobulin test negative (59.3%) among newborns their jaundice appearance within 24 hours after birth. And 31 cases were direct antiglobulin test positive (96.9%) and 46 cases were direct antiglobulin test negative (78.0%) among those their jaundice appearance within 48 hours after birth. There were statistical significant differences between the two groups (p<0.05). The peaking time of the total serum bilirubin in direct antiglobulin test positive group was earlier than that of negative group (p<0.05). The incidence of anemia in direct antiglobulin test positive group was higher than that of negative group (p<0.05). Conclusion:There were no relevance between A-blood type and B-blood type of newborns in terms of gestational age, birth weight, first time of jaundice appearance, the peaking time of the total serum bilirubin (TSB), peak of the total serum bilirubin, the incidence of anemia, the rate of direct antiglobulin test positive and the rate of direct antiglobulin test negative. Neonates of ABO hemolytic disease with direct antiglobulin test positive and antibody release positive jaundice appeared earlier, the total serum bilirubin reached the peak earlier and incidence of anemia was higher. These newborns need longer time of phototherapy than those with direct antiglobulin test negative and antibody release positive.