The Correlation Of IgG Anti A(B) Titer And Subclass To ABO-HDN In Yunnan Type O Pregnant Women

Objective:To study the correlation of IgG anti A(B)titer and subtype of anti A(B)and ABO neonatal hemolytic disease in Yunnan area and the clinical value of IgG anti A(B)subtype detection,in order to prevent the occurrence of ABO-HDN and prevent fetus from severe hemolysis,abortion,premature birth,fetal death,fetal malformation,and provide a theoretical basis for treatment of children with ABO-HDN.Methods:1.a retrospective analysis of 1482 cases of O type Rh(D)positive blood in pregnant women from January 2014-2017 years to our hospital,>16 weeks of pregnancy,serum IgG anti A(B)antibody titer of pregnant women with ABO-HDN onset,pregnant women's age,pregnancy,birth,nationality,and husband blood group.According to the blood type and sex of ABO-HDN children,indexes of TBIL,DBIL,IBIL,HB,Ret%,LDH and so on,the correlation between the titer and the general index,the condition and the severity of jaundice in children with ABO-HDN was analyzed.2.Microcolumn gel assay was used to detect the blood group of couples who were detected in the hospital in December-2017 May 2017,the detection of irregular pregnant women,the anti A(B)antibody titer of the pregnant women and the three test of the hemolysis of the newborns.Microcolumn agglutination method was used to detect the serum IgG subtypes of 32 ABO-HDN children and the serum IgG subtypes of 27 randomly selected mothers without ABO-HDN neonates.Automatic biochemical analyzer was used to detect TBIL,DBIL and IBIL in children with ABO-HDN.The children of ABO-HDN were divided into the mild jaundice group and the moderate and severe group.The logistic regression analysis of the factors of ABO-HDN was carried out to analyze the relationship between the serum IgG subtypes and the incidence of ABO-HDN in pregnant women,and the correlation between the subtype and the severity of the jaundice in the children.Results:1.110 cases of.1482 type O pregnant women were diagnosed with ABO-HDN and the incidence rate was 7.42%.With the increase of titer,the incidence of ABO-HDN was also increased,but not IgG anti A(B)antibody titer less than 1:64 was absolutely safe.The data showed that the valence of<1:32,ABO-HDN occurrence rate was 1.26%.When the titer was 1:32,the incidence of ABO-HDN was 1.47%.When the titer was 1:64,the occurrence rate of ABO-HDN was 5.26%.However,>1:512 was not entirely pathogenic,only 36.84%.The titer was positively correlated with the age,parity and parity of pregnant women.There was no significant difference in titer between the group of pregnant women over 30 years old and under the age of 30 years.The difference in the titer of group>2 and the group of 1-2 times was statistically significant,and the difference between the titer of the group more than 2 times and the 1 group was statistically significant.The titer of IgG anti A(B)antibody in pregnant women,between Han and non Han people,the analysis of titer between the Bai,Hui,Yi and other ethnic groups showed that there was no statistical difference.The result of different husbands' blood group showed that the difference of P<0.05 was statistically significant,and that the husband was more efficient than AB,and the blood type and sex of children with ABO-HDN and sex and sex were different.There was no statistically significant difference between the mothers' titer,and the parity,Ret%and HB were correlated with the mother's titer,of which the parity,Ret%were positive,HB was negatively correlated with titer,and the other pregnancies,TBIL,DBIL,IBIL,LDH and titer were not related.2.The difference of serum IgG four subclass of two groups of pregnant women in group ABO-HDN and non ABO-HDN group was statistically significant.IgG2 was a risk factor for HDN,and each increased level of IgG2,and the risk of ABO-HDN was increased by 3.706 times.The difference between IgGl and IgG2 in mild group and moderate severe group was statistically significant,there was no significant difference between IgG3 and IgG4 groups.Conclusion:1.prenatal pregnant women with IgG anti A(B)antibody titer had a certain value for predicting the occurrence of ABO-HDN,but the accuracy was not high enough.It could not be used only with the serum IgG anti A(B)antibody titer of prenatal pregnant women,as an indicator of intervention in the treatment of ABO-HDN and the evaluation of the severity of jaundice in children.2.IgG subclass was associated with the occurrence of ABO-HDN,and IgG2 was a risk factor for the pathogenesis of ABO-HDN.The serum IgG1 and IgG2 in pregnant women were associated with the degree of jaundice in children with ABO-HDN.