부산대학교 도서관

Background and Objectives: ABO haemolytic disease of the fetus and newborn (HDFN) is a lesser recognized entity; however, the severity may vary in neonates. This prospective observational study was performed to determine the severity and risk of ABO‐HDFN in neonates born to O group mothers. Materials and Methods: A total of 260 neonates born to non‐alloimmunized blood group O mothers were recruited. Blood group O neonates were excluded from the study. Neonatal direct antiglobulin test (DAT) was performed using the column agglutination technique. They were monitored for clinical and laboratory parameters and followed up at 6–8 weeks. The maternal anti‐A and anti‐B titres (IgM and IgG) were also done. Results: A total of 176 neonates with blood group A (77/260; 29.6%) and B (99/260; 38.1%) were finally included in the study, and 15 (8.5%) of them were DAT positive. Overall, 26.7% (47/176) neonates received phototherapy, 172 (97.7%) survived and none required readmission. The median (inter‐quartile range [IQR]) maternal IgG anti‐B titre (32 [32–64]) was significantly higher (p < 0.001) than the IgG anti‐A titre (16 [8–64]). The maximum total serum bilirubin in neonates had a significant positive association with neonatal birth weight (p = 0.045), positive DAT (p = 0.006) and requirement of phototherapy (p < 0.001). The relative risk (95% CI) of a DAT‐positive neonate requiring phototherapy was 4.55 (3.12–6.33). Conclusion: The frequency of ABO incompatibility in neonates born to group O mothers was 67.69% (176/260). The maternal IgG titre of ≥64 could be a good predictor for identifying the neonates at risk of developing hyperbilirubinaemia requiring phototherapy. [ABSTRACT FROM AUTHOR]