Background: Among term infants, ABO incompatibility is a leading cause of hemolytic disease and neonatal jaundice. With respect to preterm infants, data is lacking.
Objective: To evaluate the prevalence and severity of ABO incompatibility hemolytic disease among preterm infants with respect to hemolytic and jaundice parameters.
Design: Clinical and laboratory data were collected retrospectively from the medical records of 118 consecutive ABO-incompatible preterms born at gestational age 28-34 weeks, as well as 118 controls matched for gestational age, birth weight and multiplicity. All infants were born at the Sheba Medical Center Tel-Hashomer, between 2009 2012.
Results: The study and control groups were similar in all maternal and neonatal outcome parameters. No differences between the groups were recorded throughout hospitalization regarding hematocrit levels or the need for blood transfusion. Bilirubin levels were higher among the study (ABO incompatible) group during the first ten days of life; however, no significant differences were found regarding the need for phototherapy. Upon evaluating subgroups divided by GA, we found no differences on all hematological and jaundice factors among preterms of 28-31 weeks, while among preterm of 32-34 weeks higher positive Coombs test results (7% Vs 0% in the control, P= 0.014) as well as higher bilirubin levels were documented.
Conclusions: Among ABO incompatible preterm infants, there appears to be no evidence of significant hemolytic reaction derived from placental transfer of antibodies. It seems that with increasing GA, antibody transfer becomes more significant, resulting in higher positive Coombs test results and greater prevalence of neonatal jaundice.
