[The Value of IgG Anti-A/Anti-B Antibody Titers after Absorption of IgG Anti-AB Antibodies in Predicting ABO Fetal Neonatal Hemolytic Disease].

OBJECTIVE

To analyze the diagnostic value of IgG anti-A/anti-B antibody titer in the serum of type O pregnant women after absorption of IgG anti-AB antibody for ABO hemolytic disease of fetus and newborn (ABO-HDFN).

METHODS

From February 2020 to September 2020, 235 samples of neonatal hemolytic disease whose mother's blood type O from Beijing Blood Center were selected. The titer of IgG anti-A/anti-B antibody in mother's serum before and after absorption of IgG anti -AB antibody was detected by microcolumn gel card, and the incidence of ABO-HDFN was statistically analyzed. The titer level of IgG anti-A/ant-B antibody and the incidence of ABO-HDFN were compared before and after the absorption of IgG anti-AB antibody, and the diagnostic efficacy of the titer level of IgG anti -A/anti-B antibody in the serum of type O pregnant women after the absorption of IgG anti-A and B antibodies on the incidence of ABO-HDFN was analyzed using the receiver's work characteristic (ROC) curve.

RESULTS

Of the 235 neonatal hyperbilirubinemia samples with maternal blood type O, 127 were blood type A, 38 of which were diagnosed as ABO-HDFN; 108 were blood type B, of which 31 were diagnosed as ABO-HDFN. Before and after absorption of IgG anti-AB antibody, there was a significant difference in the titer of IgG anti-A/anti-B antibody ( < 0.05). Among the 69 confirmed cases, the incidence of ABO-HDFN increased with the increase of IgG anti-A/anti-B antibody with or without the IgG anti-AB antibody, but the anti-A/anti-B antibody titer ≥1∶512 before the absorption of IgG anti-AB antibody, while the anti-A/anti-B antibody titer decreased significantly, decreasing by three titers, all≤1∶512. The ROC curve shows that the titers of IgG anti-A/anti-B antibodies before and after absorption of IgG anti-AB antibodies can be used as the efficacy indicators for the diagnosis of ABO-HDFN. However, there was a significant difference in the potency of IgG anti-A/anti-B antibody titer for the diagnosis of ABO-HDFN before and after the absorption of IgG anti-AB antibody ( < 0.05). The AUC values were greater than before absorption, indicating that the IgG anti-A/anti-B antibody after the absorption of IgG anti-AB antibody was better than before absorption ( < 0.05).

CONCLUSION

The higher the titer of IgG anti-A/anti-B antibody measured after absorbing IgG anti-AB antibody, the higher the incidence of ABO-HDFN. In addition, the efficacy of IgG anti-A/anti-B antibody titer to diagnose ABO-HDFN after absorption of IgG anti-AB antibody is higher than that before absorption.