Department of Pediatrics, Almana General Hospital, Al-Ahsa, Saudi Arabia.
Department of Pediatrics, King Abdulaziz Hospital, Ministry of National Guard Hospital, Al-Ahsa, Saudi Arabia.
J Neonatal Perinatal Med. 2023;16(2):311-317. doi: 10.3233/NPM-221136.
ABO incompatibility is a major risk factor for neonatal indirect hyperbilirubinemia (NIH), requiring treatment. It has been shown that there are racial differences in direct antiglobulin test (DAT) positivity and phototherapy need in the O--B versus (vs) O--A incompatibility. The comparison between the O--B and O--A incompatibility is not well studied in Saudi Arabia.
We aimed to compare DAT positivity and phototherapy need in O-B vs O-A incompatibility in Saudi Arabia.
This retrospective cohort study was conducted in one Saudi hospital. We included a convenience sample of neonates born between 01 January 2013 and 31 December 2021. We included healthy neonates admitted to the nursery care unit only, born at≥38 weeks gestation, and had normal G6PD levels. Neonates that had no G6PD level measurement or lost follow-up post-discharge were excluded. The data span was the first 14 days of life.
A total of 611 neonates met our inclusion criteria. Positive DAT was more prevalent in the O-B than the O-A incompatibility [43.5% vs 29.2%, p < 0.001). A greater odd of phototherapy need was observed in the O--B vs O-A incompatibility across various strata. Readmission for NIH, use of 360° exposure phototherapy, or intravenous immunoglobulin administration was more prevalent in the O-B than the O-A incompatibility (13.2% vs 5.0%, p < 0.001). A logistic regression analysis revealed that the O-B incompatibility modified the association between DAT positivity and phototherapy need.
The O-B incompatibility had a mediator effect on the relationship between DAT positivity and the need for phototherapy in the study population, which emphasizes that the O-B and O-A are not the same from the NIH point of view.
ABO 血型不合是新生儿间接高胆红素血症（NIH）的一个主要危险因素，需要治疗。已经表明，在 O--B 与 O--A 血型不合之间，直接抗球蛋白试验（DAT）阳性和光疗需求存在种族差异。在沙特阿拉伯，O--B 与 O--A 血型不合之间的比较尚未得到充分研究。
我们旨在比较沙特阿拉伯 O-B 与 O-A 血型不合之间 DAT 阳性和光疗需求的差异。
这是一项在沙特阿拉伯一家医院进行的回顾性队列研究。我们纳入了一个方便样本，包括 2013 年 1 月 1 日至 2021 年 12 月 31 日期间出生的新生儿。我们纳入了仅在新生儿保育单元住院、胎龄≥38 周且 G6PD 水平正常的健康新生儿。没有进行 G6PD 水平测量或出院后失去随访的新生儿被排除在外。数据范围是出生后的前 14 天。
共有 611 名新生儿符合纳入标准。O-B 血型不合的 DAT 阳性更为常见[43.5%比 29.2%，p<0.001）。在各种分层中，O--B 比 O-A 血型不合更有可能需要光疗。O-B 比 O-A 血型不合的 NIH 再入院率、360°暴露光疗或静脉注射免疫球蛋白使用率更高（13.2%比 5.0%，p<0.001）。Logistic 回归分析显示，O-B 血型不合修饰了 DAT 阳性与光疗需求之间的关联。
在研究人群中，O-B 血型不合对 DAT 阳性与光疗需求之间的关系具有中介效应，这强调了从 NIH 角度来看，O-B 和 O-A 并不相同。
