Research Of He Relationship Between IgG Blood Group Antibody Titer Of Pregnant Women And The Incidence Of Hemolytic Disease Of The Newborn

Objective:To analyze the influence about type O blood of pregnant women indifferent pregnancy times to ABO hemolytic disease of newborn(ABO-HDN); and to explore the relationship between type O blood ofpregnant women IgG antibody titer and the incidence of hemolytic diseaseof the newborn (HDN),and to explore the relationship between type Oblood of pregnant women IgG antibody titer and the degree of hemolysis ofhemolytic disease of the newborn (HDN);furthermore,to study therelationship between the ABO-HDN blood type distribution and theoccurrence of ABO-HDN.Methods:During the period of26months from November2012to January2015,Maternal and Child Health Hospital of Jilin Province, have received725blood type O of pregnant women that met the inclusion criteria(excludingirregular antibodies positive pregnant women, pregnant women withouthistory of blood transfusion, no liver and kidney and blood system disease,excluding pregnant women RHD blood group negative, sea anemia inneonatal asphyxia and neonatal G-6PD enzyme deficiency neonates etc.newborn full-term production)and whose husbands were not blood type O. The number of ABO-HND was116cases and the clinical data of thesecases were retrospectively analyzed. Firstly, according to the number ofpregnancy,the mothers were divided into two groups of the first pregnancygroup and non first pregnancy group. There were382cases in firstpregnancy group and343cases in non pregnancy group. Then compare theeffects of different pregnancy times on the occurrence of ABO hemolyticdisease of the newborn. Secondly, according to the ABO blood type ofpregnant women’s husbands, the cases were divided into blood type O-Agroup and blood type O-B group and blood type O-AB group, in which theblood type O-A group was284cases, blood type O-B group was265cases,and blood type O-AB group was176cases, then to explore the relationshipbetween different blood type of pregnant husbands and the occurrence ofABO-HND. Finally, monitor IgG antibody titer in vivo of type O blood ofpregnant women dynamically. through the results of the determination offetal improved direct antiglobulin test (i.e., the modified Coombs test),antibody release test, free antibody test and indirect bilirubin, analyze therelationship between the IgG antibody titer of pregnant women and theincidence relation and the degree of hemolysis of hemolytic disease ofnewborn (HDN).Results:In first pregnancy group, occurrence of hemolytic disease of thenewborn of titer of less than or equal to1:64was0case. There were8 cases of titer of1:128(8/26), the titer of1:256was9cases (9/20), the titerof1:512was2cases (2/4) and titer of more than1:512was2cases (2/3);In non first pregnancy group, occurrence of hemolytic disease of thenewborn of titer of less than or equal to1:64was0case. There were32cases of titer of1:128(32/78), the titer of1:256was26cases (26/46), thetiter of1:512was24cases (24/28) and titer of more than1:512was13cases (13/13).Blood type O-A group of wife and husband was284cases, blood typeO-B group was265cases and blood type O-AB group was176cases. O-Atype, O-B type and O-AB type occurred in ABO-HDN accounted for30.6%(87/284),28.3%(75/265) and33%(58/176) respectively. There wasno statistically significant difference (P>0.05).IgG A (B) antibody with different titer group in maternal fetal ABOblood incompatibility cases was <1:64377cases,1:64group of130cases,104cases in1:128group,66cases in1:256group,32cases in1:512groupand>1:512group of16cases. Furthermore the positive rate of ABO-HDNwas respective0,0,38.5%(40/104),53%(35/66),81.3%(26/32), and93.8%(15/16). The difference was statistically significant (P<0.05). Serumindirect bilirubin were tested about HDN after delivery. After comparing toIgG antibody titer of the pregnant woman, we found that along with theantibody titer of the pregnant woman in vivo increased, serum indirectbilirubin levels showed a tendency to increase. This shows that maternal antibody titer levels can influence serum indirect bilirubin.Conclusions：The incidence rate of ABO-HDN in non first time pregnant women ishigher than the first pregnancy. Along with the antibody titer of thepregnant woman in vivo increased, the incidence rate of the hemolyticdisease of the newborn increases and the serum indirect bilirubin levelsshow a tendency to increase. But the occurrence of ABO-HDN has nosignificant relationship with the husbands of the pregnant women.Therefore, for the pregnant women with non first pregnancy and antibody>1:64, clinical doctors should give enough attention, to ensure earlydetection, early diagnosis and early treatment. Reduce the occurrence ofbilirubin encephalopathy, neurological sequelae and death.