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Hemolysis and hyperbilirubinemia in antiglobulin positive, direct ABO blood group heterospecific neonates.
J Pediatr. 2010 Nov; 157(5):772-7.JPed

Abstract

OBJECTIVE

We quantified hemolysis and determined the incidence of hyperbilirubinemia in neonates who were direct antiglobulin titer (DAT)-positive, ABO heterospecific, and compared variables among O-A and O-B subgroups.

STUDY DESIGN

Plasma total bilirubin (PTB) was determined before the neonates were discharged from the hospital and more frequently when clinically warranted, in neonates who were DAT positive with blood group A or B and with mothers who had blood group O. Heme catabolism (and therefore bilirubin production) was indexed by blood carboxyhemoglobin corrected for inspired carbon monoxide (COHbc). Hyperbilirubinemia was defined as any PTB concentration >95th percentile on the hour-of-life-specific bilirubin nomogram.

RESULTS

Of 164 neonates, 111 were O-A and 53 O-B. Overall, hyperbilirubinemia developed 85 neonates (51.8%), and it tended to be more prevalent in the O-B neonates than O-A neonates (62.3% versus 46.8%; P = .053). Hyperbilirubinemia developed in more O-B newborns than O-A newborns at <24 hours (93.9% versus 48.1%; P< .0001). COHbc values were globally higher than our previously published newborn values. Babies in whom hyperbilirubinemia developed had higher COHbc values than the already high values of babies who were non-hyperbilirubinemic, and O-B newborns tended to have higher values than their O-A counterparts.

CONCLUSIONS

DAT-positive, ABO heterospecificity is associated with increased hemolysis and a high incidence of neonatal hyperbilirubinemia. O-B heterospecificity tends to confer even higher risk than O-A counterparts.

Authors+Show Affiliations

Department of Neonatology, Shaare Zedek Medical Center, Jerusalem, Israel; Faculty of Medicine, The Hebrew University, Jerusalem, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20598320

Citation

Kaplan, Michael, et al. "Hemolysis and Hyperbilirubinemia in Antiglobulin Positive, Direct ABO Blood Group Heterospecific Neonates." The Journal of Pediatrics, vol. 157, no. 5, 2010, pp. 772-7.
Kaplan M, Hammerman C, Vreman HJ, et al. Hemolysis and hyperbilirubinemia in antiglobulin positive, direct ABO blood group heterospecific neonates. J Pediatr. 2010;157(5):772-7.
Kaplan, M., Hammerman, C., Vreman, H. J., Wong, R. J., & Stevenson, D. K. (2010). Hemolysis and hyperbilirubinemia in antiglobulin positive, direct ABO blood group heterospecific neonates. The Journal of Pediatrics, 157(5), 772-7. https://doi.org/10.1016/j.jpeds.2010.05.024
Kaplan M, et al. Hemolysis and Hyperbilirubinemia in Antiglobulin Positive, Direct ABO Blood Group Heterospecific Neonates. J Pediatr. 2010;157(5):772-7. PubMed PMID: 20598320.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hemolysis and hyperbilirubinemia in antiglobulin positive, direct ABO blood group heterospecific neonates. AU - Kaplan,Michael, AU - Hammerman,Cathy, AU - Vreman,Hendrik J, AU - Wong,Ronald J, AU - Stevenson,David K, Y1 - 2010/07/02/ PY - 2010/01/23/received PY - 2010/04/08/revised PY - 2010/05/14/accepted PY - 2010/7/6/entrez PY - 2010/7/6/pubmed PY - 2010/11/3/medline SP - 772 EP - 7 JF - The Journal of pediatrics JO - J Pediatr VL - 157 IS - 5 N2 - OBJECTIVE: We quantified hemolysis and determined the incidence of hyperbilirubinemia in neonates who were direct antiglobulin titer (DAT)-positive, ABO heterospecific, and compared variables among O-A and O-B subgroups. STUDY DESIGN: Plasma total bilirubin (PTB) was determined before the neonates were discharged from the hospital and more frequently when clinically warranted, in neonates who were DAT positive with blood group A or B and with mothers who had blood group O. Heme catabolism (and therefore bilirubin production) was indexed by blood carboxyhemoglobin corrected for inspired carbon monoxide (COHbc). Hyperbilirubinemia was defined as any PTB concentration >95th percentile on the hour-of-life-specific bilirubin nomogram. RESULTS: Of 164 neonates, 111 were O-A and 53 O-B. Overall, hyperbilirubinemia developed 85 neonates (51.8%), and it tended to be more prevalent in the O-B neonates than O-A neonates (62.3% versus 46.8%; P = .053). Hyperbilirubinemia developed in more O-B newborns than O-A newborns at <24 hours (93.9% versus 48.1%; P< .0001). COHbc values were globally higher than our previously published newborn values. Babies in whom hyperbilirubinemia developed had higher COHbc values than the already high values of babies who were non-hyperbilirubinemic, and O-B newborns tended to have higher values than their O-A counterparts. CONCLUSIONS: DAT-positive, ABO heterospecificity is associated with increased hemolysis and a high incidence of neonatal hyperbilirubinemia. O-B heterospecificity tends to confer even higher risk than O-A counterparts. SN - 1097-6833 UR - https://wwww.unboundmedicine.com/medline/citation/20598320/Hemolysis_and_hyperbilirubinemia_in_antiglobulin_positive_direct_ABO_blood_group_heterospecific_neonates_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3476(10)00428-2 DB - PRIME DP - Unbound Medicine ER -