The early diagnostic value of 3 items of umbilical cord blood hemolysis for ABO hemolytic disease of the newborn

Abstract

Objective To observe the early diagnostic value of 3 items of umbilical cord blood hemolysis (free antibody test, antibody release test, and direct anti human globulin test) for ABO hemolytic disease of the newborn (ABO-HDN). Methods A retrospective analysis was carried out in 90 cases of newborns born in our hospital from October 2015 to October 2017 whose mothers' ABO blood type were incompatible. Peripheral venous blood and umbilical cord blood were extracted, and RH, ABO blood group, and the level of percutaneous bilirubin were detected. 3 items of hemolysis tests were carried out to observe the results of peripheral venous blood and umbilical cord blood. Results There were 71 positive cases in 3 items of hemolysis tests of peripheral venous blood, and 19 negative cases; there were 63 positive cases in 3 items of hemolysis tests of umbilical cord blood, and 27 negative cases, the diagnostic sensitivity was 66.67%, the specificity was 98.41%, the diagnostic accuracy was 88.89%, the positive predictive value was 94.74%, the negative predictive value was 87.32%, Kappa value was 0.71. The diagnosis rate of O/A blood group for ABO-HDN was 92.59%, and the O/B blood group was 83.33%, without statistically significant difference (P>0.05). The ROC curve showed that bilirubin in umbilical cord blood had certain predictive value for ABO hemolytic disease of the newborn. When the mother and infant were O/A blood group and O/B blood group, the area under the curve was 0.897 and 0.943 respectively. Conclusion 3 items of hemolysis tests of umbilical cord blood have important early diagnostic value for ABO-HDN, with high accuracy and sensitivity. Key words: Umbilical cord blood; 3 items of hemolysis tests; Newborns; ABO hemolytic disease