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Maternal IgG anti‐A and anti‐B titres predict outcome in ABO‐incompatibility in the neonate
Author(s) -
Bakkeheim Egil,
Bergerud Unni,
SchmidtMelbye AnneChristine,
Akkök Çiğdem Akalin,
Liestøl Knut,
Fugelseth Drude,
Lindemann Rolf
Publication year - 2009
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2009.01478.x
Subject(s) - medicine , abo blood group system , antibody , kernicterus , group b , immunoglobulin g , group a , immunology , blood transfusion , offspring , pediatrics , gastroenterology , jaundice , pregnancy , biology , genetics
Aim: To evaluate predictors for risk of severe hyperbilirubinaemia and kernicterus in ABO‐incompatible neonates with emphasize on maternal IgG anti‐A/‐B titres. Methods: Blood group O women in labour at Oslo University Hospital, Ullevål, were included in the years 2004–2006. Offspring with blood group A or B had direct antiglobulin test performed and IgG anti‐A/‐B levels measured in maternal plasma. Blood group A or B infants developing severe hyperbilirubinaemia, received in addition to phototherapy, immunoglobulin treatment and/or exchange transfusion (EXT). Results: Of 253 neonates, 61.3% had blood group O, 29.6% blood group A and 9.1% blood group B. Twenty neonates with blood group A or B received at least one immunoglobulin treatment. In multivariate analysis, maternal antibody‐titres were the only significant predictors for immunoglobulin treatment (p < 0.0001), EXTs (p < 0.05) and duration of phototherapy (p < 0.0001). The need for invasive treatment increased sharply for antibody titres ≥512. Receiver operating characteristic analyses demonstrated that titres ≥512 had a sensitivity of 90% and a specificity of 72% for predicting immunoglobulin treatment and thus severe hyperbilirubinaemia. Conclusion: Maternal IgG anti‐A/‐B titres contribute to the prediction of risk of severe hyperbilirubinaemia in ABO‐incompatible neonates, in addition to blood‐grouping and direct antiglobulin‐testing, especially following early discharge after delivery.