[Analysis of Screening Results in 501 Newborns with Hemolytic Disease].

OBJECTIVE

To explore the relationship between the serological detection of neonatal hemolytic disease (HDN) and related factors, and to observe the detection rate and specificity of the antibodies against the blood group in the newborn hemolytic disease.

METHODS

Maternal-neonatal blood type was detected firstly, and then the direct antiglobulin test(DAT), the free antibody test and the antibody release test were used to detect the occurrence of HDN; For those suspected hemolytic disease except ABO or direct DAT result over 2+, the indirect antiglobulin test with irregular antibody were used for screening cells and the plasma of the patient and mother, and then to detezmine whether there is a corresponding antigen in the red blood cells of the patient to confirm whether hemolytic disease of the other blood type system exists or not. The analysis was carried out by SPSS 22 software. The statistical analysis of classified data was tested by χ test. P<0.05 was considered as statistically significance.

RESULTS

A total of 501 cases of hyperbilirubinemia were collected. Among them 250 cases of HDN were diagnosed as HDN, and the detection rate was 49.90%.The detection rate of the male was 45.14%, and that of the female was 56.34%(χ =6.143, P<0.05). The average day-age of patients was 3.97±2.81 days. The analysis of relatianship between the detected rate of HDN and the day-age of HDN chilren showed that the day-age of HDN chilren affected the detected rate of HDN(χ =63.489, P<0.05). The analysis of positive rate of 3 test in HDN childen of every group found that the day-age had an infuence on the detected rate of direct antiglobulin test(χ=18.976，P<0.01) and also had an influence on the detected rate of the free antibody test(χ=9.650，P<0.05). The positive rate of the release test in HDN patients was highest（100%）. 244 cases suffered from ABO hemolysis, including 1 case of ABO hemolysis combined with Rh system (anti -E) hemolysis, 4 cases of Rh system (anti -D), 2 cases of MN system (1 case was caused by anti -M, 1 case was caused by low frequency anti -Mur). ABO HDN caused by anti-A or anti-B were not statisticaly significant.

CONCLUSION

Hemolytic disease of the newborn is a common cause of neonatal hyperbilirubinemia. The positive rate of HDN has a certain relations with the sexual distinction and the day-age. But there is no significant difference between anti-A and anti-B type. At the same time, screening and identification of irregular antibodies should be carried out to avoid diagnostic errors caused by undetected antibody when necessary.