Frequency of ABO Incompatibility in Neonates as Cause of Neonatal Jaundice admitted in a Neonatal Unit of Tertiary Care Hospital
DOI:
https://doi.org/10.51253/pafmj.v74i3.6835Keywords:
ABO incompatibility, Blood group system, Indirect bilirubin, JaundiceAbstract
Objective: To determine the frequency of maternal-fetal ABO incompatibility in newborns with neonatal jaundice.
Study Design: Cross-sectional study.
Place and Duration of Study: Neonatal Intensive Care Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan from Apr 2020 to Jan 2021.
Methodology: All full-term newborns of either gender presenting with neonatal jaundice and need of phototherapy were consecutively enrolled. ABO blood incompatibility in neonatal jaundice was labelled as positive based on the presence of increased levels of serum indirect bilirubin in a newborn with blood group type A or B and maternal blood group type O. Information was collected regarding gender, birth weight, duration of hospital stay, hemoglobin level on admission, hematocrit level, indirect bilirubin level, direct Coombs test, duration of phototherapy, and need for intravenous immunoglobulin therapy.
Results: Of 225 neonates, the mean birth weight was 3283.12±1116.11 grams. The ABO incompatibility was observed in 37(16.4%) infants. The findings of multivariable analysis revealed that, after adjusting for other covariates, the odds of ABO incompatibility was 3.28 times higher among neonates with hemolysis as compared to the neonates without hemolysis (aOR 3.28, 95% CI 1.42-7.71). Similarly, after adjusting for other covariates, the odds of ABO incompatibility was 3.53 times higher among neonates with >50 hours of phototherapy duration as compared to neonates with ≤50 hours of phototherapy duration (aOR 3.53, 95% CI 1.40-8.89).
Conclusion: In conclusion, 16.4% newborns with neonatal jaundice were ABO incompatible. Moreover, hemolysis and longer phototherapy requirement were considerably higher in these neonates than those who were not ABO incompatible.
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- Oyapero O, Disu AE, Njokanma FO. Clinical and sociodemographic correlates of neonatal jaundice at a tertiary health facility in Lagos, Nigeria. Adv Hum Biol 2018; 8(2): 117-123. https://doi.org/10.4103/AIHB.AIHB_68_17
- Mitra S, Rennie J. Neonatal jaundice: aetiology, diagnosis and treatment. Br J Hosp Med 2017; 78(12): 699-704.
https://doi.org/10.12968/hmed.2017.78.12.699
- Serifat AF, Angela UC, Tongo O. Prevalence and factors associated with neonatal jaundice: A case study of university college hospital, Ibadan. IOSR J Dent Med Sci 2015; 14(4): 17-23.
- Helal NF, Ghany EAGA, Abuelhamd WA, Alradem AYA. Characteristics and outcome of newborn admitted with acute bilirubin encephalopathy to a tertiary neonatal intensive care unit. World J Pediatr 2019; 15(1): 42-48.
https://doi.org/10.1007/s12519-018-0200-4
- Du L, Ma X, Shen X, Bao Y, Chen L, Bhutani VK, et al. Neonatal hyperbilirubinemia management: Clinical assessment of bilirubin production. Semin Perinatol 2021; 45(1): 151351.
https://doi.org/10.1016/j.semperi.2020.151351
- Mehta R, Petrova A. Direct antiglobulin test in the prediction of hyperbilirubinemia and predischarge bilirubin levels in infants with mother-infant blood type incompatibility. Pediatr Neonatol 2021; 62(4): 406-411.
https://doi.org/10.1016/j.pedneo.2021.04.002
- Yigit S, Gursoy T, Kanra T, Aydin M, Erdem G, Tekinalp G, et al. Whole blood versus red cells and plasma for 1exchange transfusion in ABO haemolytic disease. Trans Med 2005; 15(4): 313-318.
https://doi.org/10.1111/j.0958-7578.2005.00593.x
- Bel Hadj I, Boukhris R, Khalsi F, Namouchi M, Bougmiza I, Tinsa F, et al. ABO hemolytic disease of newborn: Does newborn's blood group a risk factor? Tunis Med 2019; 97(3): 455-460.
- Abbas SH, Nafea LT, Abbas RS. Prevalence of ABO incompatibility and its effect on neonates hyperbilirubinemia. Research J Pharmacy Tech 2020; 13(1): 141-146.
- Dubey P, Shrivastava J, Choubey BP, Agrawal A, Thakur V. Neurodevelopmental outcome of healthy term newborn with serum bilirubin> 15 mg/dl at one year. J Neonatal Perinatal Med 2021; 14(3): 339-344.
https://doi.org/10.3233/npm-200511
- Abbey P, Kandasamy D, Naranje P. Neonatal Jaundice. Indian J Pediatr 2019; 86(9): 830-841.
https://doi.org/10.1007/s12098-019-02856-0
- Slusher TM, Zamora TG, Appiah D, Stanke JU, Strand MA, Lee BW, et al. Burden of severe neonatal jaundice: a systematic review and meta-analysis. BMJ Paediatr Open 2017; 1(1): e000105.
https://doi.org/10.1136/bmjpo-2017-000105
- Sabzehei MK, Basiri B, Gohari Z, Bazmamoun H. Etiologies of prolonged unconjugated hyperbilirubinemia in neonates admitted to neonatal wards. Iran J Neonatol 2015; 6(4): 37-42.
- Hodr R. ABO haemolytic disease: sex ratio and blood groups in the newborns requiring treatment. Czechoslovak Med 1989; 12(3): 125-133.
- Pashapour N, Nikibahksh AA, Golmohammadlou S. Urinary tract infection in term neonates with prolonged jaundice. Urol J 2009;4(2): 91-94.
https://doi.org/10.1016/j.earlhumdev.2008.09.256
- Ghaemi S, Fesharaki RJ, Kelishadi R. Late onset jaundice and urinary tract infection in neonates. Ind J Pediatr 2007; 74(2): 139-141. https://doi.org/10.1007/s12098-007-0006-1
- Cariani L, Romano EL, Martinez N, Montaño R, Suarez G, Ruiz I, et al. ABO-haemolytic disease of the newborn (ABO-HDN): factors influencing its severity and incidence in Venezuela. J Tropical Pediatr 1995; 41(1): 14-21.
https://doi.org/10.1093/tropej/41.1.14
- Irshad M, Muhammad A, Hussain M, Khan B, Ali N, Ahmad A et al. Prevalence of rhesus type and ABO incompatibility in jaundiced neonates. J Postgrad Med Inst 2011; 25(3): 233-239.
- Shah A, Shah CK, Shah V. Study of hematological parameters among neonates admitted with neonatal jaundice. J Evol Med Dent Sci 2012; 1(3): 203-208.
- Firouzi M, Yazdanmehr R, Eliasy H, Birjandi M, Goudarzi A, Almasian M. The prevalence of the ABO hemolytic disease of the newborn and its complications in an Iranian population. Iranian J Pediatr Hematol Oncol 2018; 8(1): 37-47.
- Bhat YR,. Morbidity of ABO haemolytic disease in the newborn. Paediatr Int Child Health 2012; 32(2): 93-96.
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