{"title":"Hyperbilirubinemia in neonates with blood group incompatibilities - A bane or a boon for the management.","authors":"Smita Mahapatra, Kaushik Patra, Swarupa Panda, Sasmita Behuria, Pratima Kumari Sahu, Madan Mohan Majhi","doi":"10.1016/j.tracli.2025.01.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Material & methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":94255,"journal":{"name":"Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Transfusion clinique et biologique : journal de la Societe francaise de transfusion sanguine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.tracli.2025.01.004","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
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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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