Kirkman H N
J Pediatr. 1977 May;90(5):717-21. doi: 10.1016/s0022-3476(77)81234-1.
The results of a Coombs test on each infant, age of onset of jaundice, and of maximum recorded serum indirect bilirubin concentration were statisically analyzed on 2,428 consecutive newborn infants who were Rh compatible with their mothers and who weighed 2.5 kg or more. The incidence of ABO isoimmune hemolytic disease was estimated by subtracting the frequency of each of these observations in ABO compatible infants from the corresponding frequency in ABO incompatible infants. This subtraction decreased the contribution of extraneous causes for jaundice and a positive Coombs reaction. As expected, these signs of hemolytic disease were found more often in ABO incompatible infants than in compatible infants. Whether detected by a positive Coombs reaction, jaundice in the first 24 hours, serum bilirubin concentrations over 10 mg/dl, or any combination thereof, the incidence of ABO disease was much higher in black neonates than in white ones. These findings indicate that early discharge of newborn infants from the hospital should not be authorized without specific assessments, especially when the infant is ABO incompatible and black.
对2428名与母亲Rh血型相容且体重2.5千克及以上的连续新生儿进行了统计学分析，分析了每个婴儿的库姆斯试验结果、黄疸发作年龄以及记录的最高血清间接胆红素浓度。通过从ABO血型不相容婴儿的相应频率中减去ABO血型相容婴儿中这些观察结果的频率，来估计ABO血型同种免疫溶血病的发病率。这种相减减少了黄疸和阳性库姆斯反应的外部原因的影响。正如预期的那样，溶血病的这些体征在ABO血型不相容婴儿中比在相容婴儿中更常见。无论是通过阳性库姆斯反应、出生后24小时内出现黄疸、血清胆红素浓度超过10mg/dl，还是上述任何组合来检测，ABO疾病在黑人新生儿中的发病率都远高于白人新生儿。这些发现表明，在没有进行具体评估的情况下，不应批准新生儿提前出院，尤其是当婴儿ABO血型不相容且为黑人时。
