Shash Hwazen A, Alkhater Suzan A
College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia.
Department of Pediatrics, King Fahad Hospital of the University, Al-Khobar 31952, Saudi Arabia.
Children (Basel). 2021 May 20;8(5):426. doi: 10.3390/children8050426.
Recommendations for the screening of hemolytic disease of the newborn (HDN) advise taking a selective approach in using the direct antiglobulin test (DAT) for mothers with blood group O or RhD-negative. This study assessed the relation of DAT results to maternal and neonatal blood groups and evaluated the risk of HDN. A retrospective analysis of all healthy newborns admitted during 2018 was performed. Of 1463 newborns, 4.4% had a positive DAT. There were 541 (37%) maternal-neonatal pairs with ABO incompatibility, most commonly born to mothers with blood group O. The cohort of neonates born to mothers with blood group O was divided into three groups: the O-A and O-B groups and the O-O group as a control. The DAT was positive in 59 (8.3%) neonates; most were in the O-B group (49.2%), whereas 13.6% were in the control group ( < 0.01). While the neonates in the O-B group were more likely to require phototherapy ( = 0.03), this finding was not related to DAT results. We found that selective testing of mothers with blood group O, mothers with blood group O or RhD-negative, neonates with blood group B, and neonates with blood group B born to mothers with blood group O or RhD-negative was ineffective in detecting phototherapy requirements. Our results indicate no difference regarding the need for phototherapy in neonates born to mothers with different blood types regardless of the DAT results.
新生儿溶血病（HDN）筛查建议对O型血或RhD阴性母亲采用直接抗球蛋白试验（DAT）的选择性检测方法。本研究评估了DAT结果与母婴血型的关系，并评估了HDN的风险。对2018年收治的所有健康新生儿进行了回顾性分析。在1463例新生儿中，4.4%的DAT结果呈阳性。有541对（37%）母婴存在ABO血型不合，最常见于O型血母亲所生婴儿。将O型血母亲所生新生儿队列分为三组：O-A组和O-B组，以及作为对照的O-O组。59例（8.3%）新生儿DAT结果呈阳性；大多数在O-B组（49.2%），而对照组为13.6%（<0.01）。虽然O-B组新生儿更有可能需要光疗（P = 0.03），但这一发现与DAT结果无关。我们发现，对O型血母亲、O型血或RhD阴性母亲、B型血新生儿以及O型血或RhD阴性母亲所生B型血新生儿进行选择性检测，在检测光疗需求方面无效。我们的结果表明，无论DAT结果如何，不同血型母亲所生新生儿在光疗需求方面没有差异。
