Han P, Kiruba R, Ong R, Joseph R, Tan K L, Wong H B
Department of Paediatrics, National University of Singapore.
Aust Paediatr J. 1988 Feb;24(1):35-8. doi: 10.1111/j.1440-1754.1988.tb01329.x.
The population in Singapore is predominantly Asian, with Chinese forming the major ethnic group. The incidence of haemolytic disease of the newborn (HDN) due to Rh incompatibility is very low. The true incidence of HDN due to ABO incompatibility is unknown. Early discharge is practised in Singapore making it important to predict severe HDN due to ABO incompatibility as this would constitute the main cause of haemolysis next to G6PD deficiency. One thousand, six hundred and eight baby-maternal pairs were typed for ABO, Rh, and tested for direct Coombs' test, maternal titre, cord bilirubin and haptoglobin levels. Two hundred and fifty-one were found to be ABO incompatible, with 141 group A and 110 group B babies. The incidence of HDN due to ABO incompatibility was 3.7% of all group O mothers. Coombs' test, maternal antibody titre, cord bilirubin and haptoglobin levels were of low predictive value for severe HDN due to ABO incompatibility. The data further support the notion that it is not cost effective to screen for ABO incompatibility.
新加坡人口以亚洲人为主，其中华人是主要族群。由Rh血型不合引起的新生儿溶血病（HDN）发病率很低。ABO血型不合导致的HDN真实发病率尚不清楚。新加坡实行早期出院制度，因此预测ABO血型不合导致的严重HDN很重要，因为这将成为继葡萄糖-6-磷酸脱氢酶（G6PD）缺乏症之后溶血的主要原因。对1608对母婴进行了ABO、Rh血型鉴定，并检测了直接抗人球蛋白试验、母亲抗体效价、脐血胆红素和触珠蛋白水平。发现251对母婴ABO血型不合，其中141名婴儿为A型，110名婴儿为B型。ABO血型不合导致的HDN发病率在所有O型血母亲中为3.7%。抗人球蛋白试验、母亲抗体效价、脐血胆红素和触珠蛋白水平对ABO血型不合导致的严重HDN预测价值较低。数据进一步支持了筛查ABO血型不合不具有成本效益这一观点。
