Maternal serum and cord blood anti-A and Anti-B antibody levels as a predictor of significant hyperbilirubinemia in newborns
BACKGROUND: Hemolytic disease of the newborn (HDN) was more common due to Rh incompatibility. Its prevalence has decreased due to introduction of Immunoglobulin G (IgG) prophylaxis against RhD antigen. HDN due to ABO incompatibility has become more common. AIM: The aim of this study was to study the...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Asian Journal of Transfusion Science |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/ajts.ajts_182_21 |
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| Summary: | BACKGROUND:
Hemolytic disease of the newborn (HDN) was more common due to Rh incompatibility. Its prevalence has decreased due to introduction of Immunoglobulin G (IgG) prophylaxis against RhD antigen. HDN due to ABO incompatibility has become more common.
AIM:
The aim of this study was to study the predictive value of umbilical cord serum and maternal serum anti-A and anti-B antibody titer for the occurrence of significant hyperbilirubinemia in newborns.
SETTINGS AND DESIGN:
This was a prospective cohort study which included 139 “O” blood group mothers and their offspring with A or B blood groups.
MATERIALS AND METHODS:
We analyzed the IgG anti-A, and anti-B antibody titers from cord blood and maternal serum and correlated them with features of significant hyperbilirubinemia. Positive predictive value (PPV), negative predictive value (NPV), sensitivity and specificity were calculated.
RESULTS:
Twenty-eight newborns out of 139 (20 %) developed significant hyperbilirubinemia and required phototherapy. One newborn required immunoglobulin infusion. Out of these 28 newborns’ maternal serum, 22 (79%) newborns’ maternal serum had IgG antibody titer of ≥128. Cord blood serum IgG antibody titer was 1:2 in all newborns, which was not significant. The direct Coombs test was positive in six (4%) newborns with maternal IgG antibody titer ≥128.
CONCLUSION:
Maternal IgG antibody titer was ≥1:128 and can predict significant hyperbilirubinemia in newborns with a sensitivity of 53.5%, specificity of 98.2%, PPV of 88%, NPV of 89%, and P value (P > 0.001). |
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| ISSN: | 0973-6247 1998-3565 |