Document Detail


Hemolysis and hyperbilirubinemia in antiglobulin positive, direct ABO blood group heterospecific neonates.
MedLine Citation:
PMID:  20598320     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We quantified hemolysis and determined the incidence of hyperbilirubinemia in neonates who were direct antiglobulin titer (DAT)-positive, ABO heterospecific, and compared variables among O-A and O-B subgroups.
STUDY DESIGN: Plasma total bilirubin (PTB) was determined before the neonates were discharged from the hospital and more frequently when clinically warranted, in neonates who were DAT positive with blood group A or B and with mothers who had blood group O. Heme catabolism (and therefore bilirubin production) was indexed by blood carboxyhemoglobin corrected for inspired carbon monoxide (COHbc). Hyperbilirubinemia was defined as any PTB concentration >95th percentile on the hour-of-life-specific bilirubin nomogram.
RESULTS: Of 164 neonates, 111 were O-A and 53 O-B. Overall, hyperbilirubinemia developed 85 neonates (51.8%), and it tended to be more prevalent in the O-B neonates than O-A neonates (62.3% versus 46.8%; P = .053). Hyperbilirubinemia developed in more O-B newborns than O-A newborns at <24 hours (93.9% versus 48.1%; P< .0001). COHbc values were globally higher than our previously published newborn values. Babies in whom hyperbilirubinemia developed had higher COHbc values than the already high values of babies who were non-hyperbilirubinemic, and O-B newborns tended to have higher values than their O-A counterparts.
CONCLUSIONS: DAT-positive, ABO heterospecificity is associated with increased hemolysis and a high incidence of neonatal hyperbilirubinemia. O-B heterospecificity tends to confer even higher risk than O-A counterparts.
Authors:
Michael Kaplan; Cathy Hammerman; Hendrik J Vreman; Ronald J Wong; David K Stevenson
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2010-07-02
Journal Detail:
Title:  The Journal of pediatrics     Volume:  157     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-10-19     Completed Date:  2010-11-02     Revised Date:  2014-09-08    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  772-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2010 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
ABO Blood-Group System / blood*
Antibodies, Anti-Idiotypic / blood*
Female
Hemolysis*
Humans
Hyperbilirubinemia, Neonatal / blood*,  complications*,  epidemiology
Incidence
Infant, Newborn
Male
Grant Support
ID/Acronym/Agency:
KL2 RR025743/RR/NCRR NIH HHS; RR00070/RR/NCRR NIH HHS; RR025744/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/ABO Blood-Group System; 0/Antibodies, Anti-Idiotypic
Comments/Corrections

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