The role of abo antibodies and molecular genotyping of blood group o in haemolytic disease of the foetus and newborn
After the introduction of anti-D prophylaxis, the incidence of Rh haemolytic disease has decreased and ABO incompatibility between the mother and the fetus is now the leading cause of neonatal jaundice associated with blood group incompatibility. Neonatal ABO incompatibility occurs mostly in grou...
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| フォーマット: | 学位論文 |
| 言語: | English |
| 出版事項: |
2013
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| 主題: | |
| オンライン･アクセス: | http://eprints.usm.my/60751/1/ADIYATU%20SAIDU%20USMAN%20-%20e.pdf http://eprints.usm.my/60751/ |
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| 要約: | After the introduction of anti-D prophylaxis, the incidence of Rh haemolytic disease
has decreased and ABO incompatibility between the mother and the fetus is now the
leading cause of neonatal jaundice associated with blood group incompatibility.
Neonatal ABO incompatibility occurs mostly in group A/B neonates delivered by
group O mothers. The severity of haemolysis ranges from mild to severe with few
neonates developing ABO haemolytic disease. Assessing and predicting the severity
of haemolysis in neonates with ABO incompatibility and haemolytic disease has
been carried out previously. This study was aimed at determining whether maternal
IgG anti-A/B titre and blood group O molecular genotype can predict haemolysis in
neonates with ABO HDFN. The severity of haemolysis was also assessed by
determining the levels of haemolytic markers in neonates with ABO incompatibility.
A total of 96 neonates with jaundice were enrolled in this study. Seventy were ABO
incompatible (study group) and 26 (control group) were ABO compatible. Sixty
mothers of the 70 ABO incompatible neonates and 30 mothers that were compatible
(mother and neonate blood group O) with their neonates were studied for maternal IgG anti-A/B titre and ABO molecular genotype. Another 34 individuals who were blood donors were also studied for blood group O molecular genotype. The result
obtained showed a significant difference (p<0.05) between the ABO incompatible
and compatible groups in relation to the laboratory features that were used in
assessing haemolysis. ABO incompatible neonates had higher levels of haemolytic
markers compared to the ABO compatible neonates. Mode of delivery type of treatment required and level of haemoglobin were significantly different between
neonates thad had ABO HDFN and does without HDFN. In neonates that had ABO
HDFN, maternal IgG anti-A/B titre was a good predictor of haemolysis when
carboxyhaemoglobin and absolute reticulocytes count were used as markers of
haemolysis. No significant difference (p>0.05) was observed between the maternal
IgG titre of ABO incompatible and compatible mothers. Of the 124 subjects that
were typed for blood group O molecular genotype, only one had a different genotype
which is 0102 but the remaining had O1O1.
This study indicates that neonatal ABO incompatibility is associated with more
haemolysis when compared with neonates with jaundice not caused by ABO
incompatibility. Concentration of maternal IgG antibody titre is not affected by
incompatible pregnancy even though maternal antibody titre can predict haemolysis.
The major ABO molecular genotype of the O blood group in Malays is O1O1. |
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