Blood group mismatch between the mother and newborn carries substantial risk for neonatal jaundice
To study the outcome of neonatal jaundice due to ABO hemolytic disease of the newborn (ABO HDN) and study the relation of epidemiological risk factors and laboratory findings with it´s severity.
PATIENTS AND METHODS:
In this prospective study, 64 neonates with neonatal jaundice associated with ABO incompatibility were studies. Cases of ABO HDN were diagnosed as those with anemia, reticulocytosis and spherocytes or polychromasia on blood film with or without positive direct Coombs test. Severity of jaundice was regarded according to the type of treatment (phototherapy or exchange transfusion).
Forty two patients (65.6%) were males, 46 patients (71.9%) were full term infants, 6 patients (9.4%) had family history of neonatal jaundice treated by exchange transfusion.
Only 9 patients (14.1%) presented with TSB level ≥ 20 mg/dl, 8 patients (12.2% ) had PCV level < 45%, 8 patient (12.5%) had reticulocyte count ≥ 5%. Direct Coombs test was negative in all the patients. Twelve patients (18.8%) had abnormal blood film findings .
Eight cases (12.5%) had the features of ABO HDN and represented 2.9% from the total admitted cases of neonatal jaundice.
Full term babies, positive family history of exchange transfusion, abnormal blood film findings and reticulocyte count were found as significant risk factors for the severity of the jaundice, while gender, body weight, blood group, mode of delivery and parity of the mothers had no significant effect on the severity of the jaundice.
Not all the cases of ABO incompatibility developed ABO HDN, so laboratory confirmation is required.