Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

Prediction of ABO hemolytic disease of the newborn using pre- and perinatal quantification of maternal anti-A/anti-B IgG titer

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  1. Predictors of outcome in children with disorders of mitochondrial metabolism in the pediatric intensive care unit

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. How to safeguard the brain of extremely preterm infants?

    Publikation: Bidrag til tidsskriftKommentar/debatForskningpeer review

  3. Gestational age-dependent development of the neonatal metabolome

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer

Background: 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. Methods: 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. Results: 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. Conclusions: There was a significant association between maternal anti-A/B IgG titer and hyperbilirubinemia requiring treatment. Impact: 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.

OriginalsprogEngelsk
TidsskriftPediatric Research
Vol/bind90
Udgave nummer1
Sider (fra-til)74-81
Antal sider8
ISSN0031-3998
DOI
StatusUdgivet - jul. 2021

ID: 61228880