Alloantibodies screening in cord blood for early detection of hemolytic disease of newborn

Background
Hemolytic disease of the newborn (HDN) is a disorder caused by antibodies from mother that pass through the placenta and attack red blood cells of fetus. Although other blood groups may potentially be implicated, Rh or ABO blood group incompatibility are the most common cause of this illness. Even though they are rarely linked to neonatal hyperbilirubinemia, minor blood group incompatibilities resulting from blood types other than Rh (D) are considered risk for significant jaundice and its complications in neonates if they are not properly identified and treated. In order to help clinicians reduce infant morbidity and improve overall patient care, the study's goal was to identify instances at elevated risk.


Study design and methods
This was a prospective observational study carried out at the women’s health hospital and central blood bank of Assiut University Hospital. ABO, Rh (D) typing, antibody screening, identification, and antibody titration tests were investigated on 250 cord blood samples and their mother’s venous samples. Additionally, cord samples were examined for indications of hemolysis using complete blood count, reticulocyte count, the direct antiglobin test (DAT), and serum bilirubin levels.


Results
Neonates who had antibodies by cord blood screening, had significantly different haemolysis indices and required hospitalisation and treatment


Conclusion
According to the present research, minor blood groups should be looked into for prompt HDN diagnosis and treatment in order to avoid serious consequences like kernicterus, which is a “never event” for the safety of newborns. Furthermore, compared to the screened group, the non-screened group had a much longer hospital stay, a far greater number of neonates receiving IVIG, and exchange transfusions.