Hyperbilirubinemia in neonates with blood group incompatibilities − A bane or a boon for the management

IF 1.4 4区医学 Q4 HEMATOLOGY

Transfusion Clinique et Biologique Pub Date : 2025-02-01 DOI:10.1016/j.tracli.2025.01.004

Smita Mahapatra , Kaushik Patra , Swarupa Panda , Sasmita Behuria , Pratima Kumari Sahu , Madan Mohan Majhi

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Abstract

Objectives

Neonatal hyperbilirubinemia, or newborn jaundice, is a common condition caused by high bilirubin levels. Blood group incompatibility between mother and baby is a major cause. This study examined the link between different blood group incompatibilities and their management in newborns with jaundice.

Material & Methods

This prospective observational study included 190 neonates with hyperbilirubinemia requiring phototherapy. They were divided into two groups: control (blood group compatible) and case (blood group incompatible). Data on demographics, investigations, and management were collected.

Results

Blood group incompatibility was present in 36.3% of cases, primarily ABO (28.9%). Rh incompatibility and ABO + Rh incompatibility accounted for 5.3% and 1.6%, respectively. DAT was positive in 32.7% of ABO incompatible cases, with anti-B more prevalent. Neonates with ABO incompatibility had the highest mean total serum bilirubin (TSB) level (13.04 mg/dL) and the largest overall decrease in TSB (–33.77%).The mean phototherapy duration was significantly longer in cases (44.1 h) compared to controls (35.5 h). ABO incompatible neonates had a longer average phototherapy duration (42.32 h) compared to controls. However, ABO+Rh and pure Rh incompatible cases had highest phototherapy duration among cases. Moreover, within ABO cases, the mean phototherapy duration was higher in DAT-positive cases (46 h) compared to DAT-negative cases (40.2 h). Delivery mode, parity, and gender did not significantly influence phototherapy duration, but gestational age might play a role.

Conclusion

Various blood group incompatibilities, beyond RhD, are significantly associated with hyperbilirubinemia requiring phototherapy. ABO incompatibility was the most common cause. Neonatal jaundice is linked to blood group mismatch, with ABO+Rh and pure Rh incompatibility requiring longer phototherapy. However, ABO incompatible cases had longer phototherapy in comparison to controls. Gestational age might influence phototherapy duration.

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高胆红素血症与血型不合的新生儿-管理的祸福。

目的：新生儿高胆红素血症或新生儿黄疸是由高胆红素水平引起的一种常见疾病。母亲和婴儿血型不合是主要原因。本研究探讨了新生儿黄疸不同血型不相容及其管理之间的联系。材料与方法：本前瞻性观察研究纳入190例需要光疗的高胆红素血症新生儿。患者分为对照组（血型相容组）和病例组（血型不相容组）。收集了人口统计、调查和管理方面的数据。结果：36.3%的病例存在血型不合，以ABO血型为主（28.9%）。Rh不相容和ABO+Rh不相容分别占5.3%和1.6%。32.7%的ABO血型不匹配病例DAT阳性，其中抗b更为普遍。ABO血型不相容新生儿的平均血清总胆红素（TSB）水平最高（13.04 mg/dL）， TSB总体下降幅度最大（-33.77%）。与对照组（35.5小时）相比，病例的平均光疗时间（44.1小时）明显更长。ABO血型不相容的新生儿与对照组相比，平均光疗时间更长（42.32小时）。而ABO+Rh和纯Rh不相容的患者光疗时间最长。此外，在ABO病例中，dat阳性病例的平均光疗时间（46小时）高于dat阴性病例（40.2小时）。分娩方式、胎次和性别对光疗持续时间没有显著影响，但胎龄可能起作用。结论：除RhD外，各种血型不相容与需要光疗的高胆红素血症显著相关。ABO血型不合是最常见的原因。新生儿黄疸与血型不匹配有关，ABO+Rh和纯Rh不相容需要更长时间的光疗。然而，与对照组相比，ABO不相容病例的光疗时间更长。胎龄可能影响光疗持续时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Transfusion Clinique et Biologique 医学-免疫学

CiteScore

2.50

自引率

11.80%

发文量

234

审稿时长

36 days

期刊介绍： Transfusion Clinique et Biologique, the official journal of the French Society of Blood Transfusion (SFTS): - an aid to training, at a European level - the only French journal indexed in the hematology and immunology sections of Current Contents Transfusion Clinique et Biologique spans fundamental research and everyday practice, with articles coming from both sides. Articles, reviews, case reports, letters to the editor and editorials are published in 4 editions a year, in French or in English, covering all scientific and medical aspects of transfusion: immunology, hematology, infectious diseases, genetics, molecular biology, etc. And finally, a convivial cross-disciplinary section on training and information offers practical updates. Readership: "Transfusers" are many and various: anesthetists, biologists, hematologists, and blood-bank, ICU and mobile emergency specialists...