| Autor: |
Grethe R, Krog, Mette L, Donneborg, Bo M, Hansen, Henriette, Lorenzen, Frederik B, Clausen, Kristian V, Jensen, Anette, Kjærbye-Thygesen, Per, Albertsen, Finn, Ebbesen, Thomas, Bergholt, Mette K, Smed, Morten H, Dziegiel |
| Rok vydání: |
2020 |
| Předmět: |
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| Zdroj: |
Pediatric research. 90(1) |
| ISSN: |
1530-0447 |
| Popis: |
Hemolysis in fetus/newborns is often caused by maternal antibodies. There are currently no established screening procedures for maternal ABO antibodies harmful to fetus/newborn. We investigated the clinical significance, and predictive value of maternal anti-A/B titer for hyperbilirubinemia in ABO-incompatible newborns.We conducted a case-control study of blood group O mothers and their ABO-compatible (O) vs. -incompatible (A/B) newborns receiving phototherapy, and of ABO-incompatible newborns receiving phototherapy vs. no phototherapy. Newborn data and treatment modalities were recorded, and total serum bilirubin and hemoglobin were measured. Maternal anti-A/B immunoglobulin-γ (IgG) titers were measured prenatally and perinatally, and negative and positive predictive values (NPV, PPV) were calculated to assess the risk of developing hyperbilirubinemia requiring phototherapy.We found a significantly higher maternal IgG antibody titer in the case group (p 0.001). Maternal anti-A/B titers at first trimester had modest predictive values: NPV = 0.82 and PPV = 0.65 for neonatal hyperbilirubinemia; titers at birth improved the predictive values: NPV = 0.93 and PPV = 0.73. Newborn hemoglobin was significantly lower in incompatibles compared to compatibles (p = 0.034). Furthermore, increased anti-A/B IgG production during pregnancy was associated with hyperbilirubinemia and hemolysis in incompatible newborns.There was a significant association between maternal anti-A/B IgG titer and hyperbilirubinemia requiring treatment.Maternal anti-A/B IgG titer in the first trimester and at birth is predictive of hemolytic disease of the ABO-incompatible newborn. Increased IgG anti-A/B production throughout pregnancy in mothers to ABO-incompatible newborns developing hyperbilirubinemia contrasts a constant or reduced production in mothers to newborns not developing hyperbilirubinemia. Screening tools available in most immunohematology laboratories can identify clinically important IgG anti-A/B. Use of maternal samples taken at birth yielded NPV = 0.93 and PPV = 0.73. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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