Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Ontario, Canada.
ICES, Toronto, Ontario, Canada.
JAMA Netw Open. 2024 Oct 1;7(10):e2442227. doi: 10.1001/jamanetworkopen.2024.42227.
Newborn immunity largely relies on maternal-fetal transfer of antibodies in utero. Incongruency in ABO blood groups between a mother and newborn may be associated with protection against serious infections, but data specific to newborn bacterial infections are lacking.
To ascertain the association between maternal-newborn ABO blood group incongruence and lower risk of bacterial infection in newborns.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study used linked patient-level datasets for all singleton live births between January 1, 2014, and December 31, 2020, in hospitals and health centers in Ontario, Canada. The cohort comprised maternal-newborn pairs with known ABO blood groups. Data analysis was conducted between February and May 2024.
Maternal-newborn ABO blood group incongruence vs congruence.
The primary outcome was a bacterial infection arising in newborns within 30 days of birth. Bacterial infection was cultured from either blood, cerebrospinal fluid, urine, or lung specimen. Secondary outcomes were a bacterial infection with 7 days and 90 days of birth. Modified Poisson regression generated adjusted relative risks (ARRs) and 95% CIs, adjusted for neonatal sex and preterm birth.
A total of 138 207 maternal-newborn pairs (maternal mean [SD] age, 31.8 [5.1] years among those with ABO blood group incongruency and 31.5 [5.1] years among those with ABO blood group congruency; newborn mean [SD] gestational age, 38.5 [2.3] weeks among those with incongruency and 38.4 [2.5] weeks among those with congruency; 19 475 males [51.3%] with incongruency and 52 041 males [51.9%] with congruency) were analyzed. Of these pairs, 37 953 (27.5%) had ABO blood group incongruency and 100 254 (72.5%) had ABO blood group congruency. Within 30 days of birth, 328 (8.6 per 1000) newborns in the incongruent group and 1029 (10.3 per 1000) newborns in the congruent group experienced a bacterial infection, corresponding to an ARR of 0.91 (95% CI, 0.81-1.03). The ARRs for bacterial infection within 7 days and 90 days of birth were 0.89 (95% CI, 0.73-1.09) and 0.86 (95% CI, 0.78-0.94), respectively.
This cohort study found no association between maternal-newborn ABO blood group incongruence and risk of bacterial infection in newborns within 30 and 7 days of birth. However, incongruence was associated with a decreased risk of bacterial infection within 90 days of birth.
新生儿的免疫力在很大程度上依赖于母体-胎儿在子宫内抗体的转移。母亲和新生儿之间 ABO 血型不合可能与预防严重感染有关，但缺乏针对新生儿细菌性感染的具体数据。
确定母婴 ABO 血型不合与新生儿细菌性感染风险降低之间的关联。
设计、设置和参与者：本队列研究使用了加拿大安大略省 2014 年 1 月 1 日至 2020 年 12 月 31 日期间所有单胎活产儿的患者级联数据集，包括在医院和健康中心的母婴对，其 ABO 血型已知。队列包括母婴 ABO 血型不合的母婴对。数据分析于 2024 年 2 月至 5 月进行。
母婴 ABO 血型不合与一致。
主要结局是新生儿出生后 30 天内发生细菌性感染。从血液、脑脊液、尿液或肺部标本中培养出细菌感染。次要结局是出生后 7 天和 90 天的细菌感染。使用修正泊松回归生成调整后的相对风险（ARR）和 95%CI，调整了新生儿性别和早产因素。
共分析了 138207 对母婴（母亲平均[标准差]年龄，ABO 血型不合者为 31.8[5.1]岁，ABO 血型一致者为 31.5[5.1]岁；新生儿平均[标准差]胎龄，ABO 血型不合者为 38.5[2.3]周，ABO 血型一致者为 38.4[2.5]周；37953 对（27.5%）有 ABO 血型不合，100254 对（72.5%）有 ABO 血型一致）。在出生后 30 天内，ABO 血型不合组的 328 名（8.6/1000）新生儿和 ABO 血型一致组的 1029 名（10.3/1000）新生儿发生了细菌感染，ARR 为 0.91（95%CI，0.81-1.03）。出生后 7 天和 90 天的细菌感染 ARR 分别为 0.89（95%CI，0.73-1.09）和 0.86（95%CI，0.78-0.94）。
本队列研究未发现母婴 ABO 血型不合与新生儿出生后 30 天内和 7 天内细菌性感染风险之间存在关联。然而，ABO 血型不合与出生后 90 天内细菌感染风险降低有关。
