Erythroblastosis Research Articles

Evidence that donors with variant RH genotypes are associated with unexpected Rh antibodies.

We previously reported unexpected Rh antibodies in the plasma of patients with sickle cell disease (SCD) that demonstrated common Rh specificities in the absence of transfusion of RBCs positive for that antigen. We hypothesize that these antibodies might result from transfusion of antigen-negative donor units with variant RH genotypes. Plasma testing by tube and IgG gel, extended RBC phenotyping, and HEA and RH genotyping were by standard methods. A 6-year-old female with SCD, phenotype D + C-c + E-e + K- undergoing exchange transfusion with CEK- and Fy(a-) units, presented with anti-C in the plasma, a + DAT and warm autoantibody (WAA) in the eluate. Her RH genotype was unremarkable: RHD*D/DAU0 and RHCE*ce/ce(48C). Units (n = 10) transfused over the prior 6 months were confirmed CEK- by serology and DNA testing. Most (n = 7) were Rh-negative. A unit with variant RH, RHD*DIIIa/weak partial 4.0, RHCE*ceVS.03/ceVS.02, was transfused 5 weeks prior. Anti-C and + DAT continued to demonstrate for 25 weeks. Total hemoglobin and % Hgb S did not deviate from her established baseline. We show direct association of plasma anti-C with transfusion of a C-negative unit with variant RH encoding partial D and uncommon V/VS+ hrB - phenotype. The antibody was transient, without evidence of compromised survival of transfused RBCs. The +DAT and WAA complicated workups and selection of units, and it is uncertain whether donors of the same genotype should be avoided. Minority donors are important for CEK-matching to avoid depleting Rh-negative supplies. Consideration of patient and donor RH genotypes may avoid unexpected antibodies and improve allocation of rare donations.

Neonatal Hemolytic Disease Caused by Anti-e and Anti-C Antibodies Treated with Intensive Phototherapy: A Case Report

ABO and Rh incompatibility are the leading causes of hemolytic disease of the fetus and newborn (HFDN). Due to the high antigenicity of the D antigen, hemolysis and symptoms progress rapidly. However, minor blood group incompatibility manifests varying clinical symptoms, from asymptomatic cases to neonatal jaundice and fetal hydrops. This study presents a case of HFDN in which anti-C and anti-e antibodies were identified and treated with intensive phototherapy. A full-term infant weighing 3,100 g at birth, with no complications during delivery, presented with jaundice and was admitted for intensive phototherapy. Antibody testing detected anti-C and anti-e antibodies in the neonate and the mother. The patient responded well to phototherapy, and intravenous immunoglobulin was administered. The total bilirubin levels decreased, and the infant was discharged after 5 days. At the age of 12 months, the infant exhibited normal neurodevelopment. In conclusion, neonates with HFDN, due to rare minor blood incompatibility, specifically anti-C and anti-e antibodies, can mitigate hyperbilirubinemia using phototherapy. Future research should also consider the severity of the minor blood group incompatibility.

Role of Subcutaneous Bilirubinometre in the Evaluation of Bilirubin Level in Neonatal Jaundice

Objectives: To record the demographic features of neonates presenting with jaundice, identify their cause, and co-relate bilirubin levels obtained by subcutaneous bilirubinometre with a standard biochemical method.
 Study Design: Cross-sectional study
 Place and Duration of Study: Nursery of Combined Military Hospital, Malir Cantt Karachi, from Jul to Dec 2020.
 Methodology: A total of 100 cases of neonatal jaundice were enrolled using a systematic random sampling technique. The demographic data of enrolled neonates and risk factors for jaundice were recorded. Their bilirubin levels were recorded using transcutaneous bilirubinometre (TCB) JH-2. Serum bilirubin levels were analyzed at the same time and recorded.
 Results: Out of 100 neonates, 61(61 %) were male. Risk factors for jaundice included exaggerated physiological 70(70%), prematurity 11(11%), Rh incompatibility 9(9%), G6PD deficiency 5(5%). For all weight ranges, mean TCB values significantly correlated with mean serum bilirubin level (p-value <0.001) with a co-relation coefficient of 0.683 and device reliability of 74%.
 Conclusion: Transcutaneous bilirubinometre can be considered a reliable tool to assess bilirubin for screening neonatal jaundice in term and pre-term neonates.

Rare Blood Group: A Golden Blood

“Golden blood” is as uncommon in fact because it turned into in historic Greek mythology: simplest forty-3 humans withinside the global are recognised to have had this blood type1.There are four essential blood groups (forms of blood) – A, B, AB and O. The first case was found in india is in Gujarat a 65 year man who had a cardiac attack and was admitted for surgery.14-July-2022.In world wide Rhnull is thought to affect 1 in every 6 million people.The medical professional has keep the record of this blood group you can contact to them.The immunoglobulin G (IgG) antibodies referred to as Rh antibodies originate from exposure to Rh-positive blood, usually when pregnant or following transfusions of blood There are total 8 types of blood groups are there Blood types also need to be compatible for organ transplants. People with the blood types Rh null or golden may have, Mild to severe hemolytic anemia from birth.

Distribution of ABO and Rh blood groups among pregnant women attending the obstetrics and gynecology clinic at the Jordan University Hospital

The ABO and D antigen status of red blood cells (Rh blood grouping systems) are important hematological classification systems that categorize blood groups according to the presence or absence of certain erythrocytic antigens. These antigens affect the outcomes of blood transfusions as well as various hematological and immunological diseases. We aimed to study ABO and Rh blood group distribution among pregnant women visiting the antenatal care clinic at Jordan University Hospital (JUH) in Amman, Jordan. A retrospective analysis of all pregnant women delivering at the Jordan University Hospital (JUH) between October 1, 2016, and September 31, 2021. ABO and D antigen status of red blood cells (Rh blood groups) were summarized and documented. 20,136 pregnant women data were analyzed, the O blood group was the most prevalent (n = 7840, 38.9%), followed by A (n = 7506, 37.3%). For the D antigen status, the Rh-positive (Rh+) category was the most common (n = 18,159, 90.2%). For the (O) blood group; O-Rh+ type was the most prevalent (90.1%). Determining the blood group type accurately helps eliminate the critical consequences of both ABO and Rh incompatibility and offers clinicians an opportunity to take timely prophylactic measures. In our analyses O and Rh+ blood groups were the most prevalent.

Clinical significances and distribution of unexpected antibodies found in infants

IntroductionThe unexpected antibody test is an essential for ensuring the safety of blood transfusions. In infants, different pre-transfusion tests and transfusion strategies are needed due to their immature antigen/antibody system. This study aims to analyze the pattern of unexpected antibodies and their clinical significance in infants. MethodsA retrospective analysis was conducted on the results of unexpected antibody identification tests performed on infants under one year of age at Asan Medical Center from 1999 to 2022. Patients’ unexpected antibody identification test results and clinical information were investigated. The results of unexpected antibody identification and phenotype of each patient’s mother were collected. Results45 cases of antibody results were studied. 25 cases were found in infants under 4 months of age, and 18 cases (76%) were associated with hemolytic disease of the fetus and newborn (HDFN). The most common unexpected antibody in infants was anti-M (17 cases). There was one case of severe HDFN caused by anti-M. In 10 cases, anti-E and anti-c were found together, and 9 of these cases were associated with HDFN. There were four cases with a history of previous transfusion. ConclusionsNon-ABO antibodies found in infants showed a different pattern compared to adults. Interpreting unexpected antibody tests in infants, it is important to consider the clinical status of the infant and the test results of the mother, due to possibility of HDFN. To our knowledge, this is the first study to reveal the distribution and clinical significances of unexpected antibodies found in infants in Korea.

Haemolytic Disease of the Newborn

Background: Immune-mediated haemolytic disease of the newborn refers to a specific category of haemolytic anaemia that results from transplacental passage of IgG antibodies from a pre-sensitized mother to her fetus in utero. This occurs due to blood group incompatibility between the mother and the fetus. The clinical presentation covers a wide spectrum spanning from still births and erythroblastosis fetalis as well as infants born with only mild haemolysis to those having severe anaemia snd severe indirect hyperbilirubinaemia followed by hydrops.Objective: We describe the journey of a Rh-D negative mother who endured through six pregnancies in order to have a healthy baby.Conclusion: To highlight the importance of blood grouping and Rh typing during the first antenatal visit and subsequent monitoring of antibody titers, especially in a mother who is Rh-D negative. KYAMC Journal Vol. 14, No. 01, April 2023: 54-56

Antibody-mediated antigen loss switches augmented immunity to antibody-mediated immunosuppression

AbstractAntibodies against fetal red blood cell (RBC) antigens can cause hemolytic disease of the fetus and newborn (HDFN). Reductions in HDFN due to anti-RhD antibodies have been achieved through use of Rh immune globulin (RhIg), a polyclonal antibody preparation that causes antibody-mediated immunosuppression (AMIS), thereby preventing maternal immune responses against fetal RBCs. Despite the success of RhIg, it is only effective against 1 alloantigen. The lack of similar interventions that mitigate immune responses toward other RBC alloantigens reflects an incomplete understanding of AMIS mechanisms. AMIS has been previously attributed to rapid antibody-mediated RBC removal, resulting in B-cell ignorance of the RBC alloantigen. However, our data demonstrate that antibody-mediated RBC removal can enhance de novo alloimmunization. In contrast, inclusion of antibodies that possess the ability to rapidly remove the target antigen in the absence of detectable RBC clearance can convert an augmented antibody response to AMIS. These results suggest that the ability of antibodies to remove target antigens from the RBC surface can trigger AMIS in situations in which enhanced immunity may otherwise occur. In doing so, these results hold promise in identifying key antibody characteristics that can drive AMIS, thereby facilitating the design of AMIS approaches toward other RBC antigens to eliminate all forms of HDFN.

Mechanism of Small Molecule Inhibitors of Phagocytosis

Immune cytopenias occur when the body produces antibodies that target specific hematopoietic cells, inducing extravascular antibody-mediated phagocytosis by monocyte-macrophages in the spleen and/or liver through activation of Fcγ Receptors (FcγRs). Immune cytopenias include Immune Thrombocytopenia (ITP), Autoimmune Hemolytic Anemia (AIHA), Hemolytic Transfusion Reactions (HTR), Hemolytic Disease of the Fetus and Newborn (HDFN), and Autoimmune Neutropenia (AIN). Thus, novel therapeutics that inhibit phagocytosis would be useful, especially for short-term use while other therapies are being evaluated. In our earlier studies, we successfully identified two small-molecule drugs able to inhibit in vitro phagocytosis with a low IC50 concentration and negligible toxicity. These drugs, known as KB-151 and KB-208, have the potential to be utilized as lead compounds for further studies, once their mechanism of action is more clearly understood. In this regard, we have developed preliminary results that suggest that these small molecules may bind to the Fc receptors on monocyte macrophages and block the subsequent attachment of antibody-opsonized red blood cells to prevent phagocytosis.

Management of anti-M antibody during pregnancy: a case report.

Anti-M antibodies are relatively common and naturally occurring. When anti-M antibodies cross the placenta, they may cause hemolytic disease of the fetus and newborn (HDFN). Anti-M antibodies account for less than 15 cases of HDFN reported in the published English literature. HDFN can lead to foetal anaemia, hydrops fetalis, hypoxia, heart failure, and even death. To review the general guidelines and propose a less intensive management approach of anti-M antibody during pregnancy through the context of a case report. We report a 25-year-old healthy pregnant G3P1011 woman presenting for antepartum care. At the time of delivery for the patient's second pregnancy, she was found to have a positive anti-M blood screen, though she birthed a healthy-term infant. For her current pregnancy, the initial and repeat testings for anti-M were positive. Since multiple samples from this patient were of low levels extensive maternal and foetal monitoring were deemed unnecessary in reflection of further reading and research. The patient had a spontaneous vaginal delivery of her third pregnancy at 38 weeks without complications. Anti-RBC antibodies, including anti-M, are frequently identified in blood type and screening for pregnant patients. Guidelines call for intensive surveillance during pregnancy; however, knowledge of the specific antibody can help to provide more nuanced and less intensive care. As primary care physicians, being familiar with the guideline and the ability to counsel patients on anticipated care during pregnancy can help with family planning, compliance with testing, and patient anxiety and decrease intensive use of services that may not affect outcomes.

Hemolytic Disease of Newborn Following Anti-C and Anti-S Alloimmunization

Background: Non-Rhesus D antigen non-ABO, minor blood group alloimmunization in pregnant women is being increasingly recognized as a significant contributor to the development of the hemolytic disease of the fetus and newborn (HDFN). We report severe HDFN in a neonate born to an Rh-positive mother with sickle cell disease, following anti-C and anti-S alloimmunization. Clinical Description: A male baby born to a repeatedly transfused mother with sickle cell disease developed severe jaundice at 22 h of life. The baby was found to have severe anemia and indirect hyperbilirubinemia, but no encephalopathy, hepatosplenomegaly, or features of sepsis. Management and Outcome: His blood group was O positive and the direct Coombs test was 4+. Minor blood group typing showed the presence of anti-C and anti-S antibodies. The baby improved after receiving a double-volume exchange transfusion with matched blood and phototherapy. Conclusion: Severe hemolytic disease of the newborn (HDN) may be caused by minor blood group alloimmunization, especially seen in mothers with a history of multiple transfusions. Antenatal screening for alloimmunization in high-risk mothers can ensure timely diagnosis and treatment of HDN and prevent the harmful effects of neonatal hyperbilirubinemia.

Epidemiological Investigation of Neonatal Jaundice in Tikrit City: Assessing Neonatal Risk Factors from 2022 to 2023

Objectives: This study aimed to assess the prevalence of neonatal jaundice and explore associated risk factors in Tikrit City, Iraq.
 Methods: The current study was a cross sectional study involved 312 neonates (204 of them with jaundice and 108 without jaundice ), attending Salahaddin General hospital from 1st October 2022 to 30th January 2023. The Study sample was convenient . Jaundiced and Non-jaundiced neonates were enrolled into the study when they enter the wards of pediatrics and neonatal intensive care unites in Salahaddin General Hospital and those visits outpatient clinics of pediatricians and the general population during a free neonatal jaundice screening campaign in Tikrit City.
 Results: The prevalence of neonatal jaundice is (9.2%). The most frequent cases was having total serum bilirubin(TSB) level ≤18 milligram/dc liter(mg\dl) (84.8%).The mean ±standard deviation (SD) of hyperbilirubinemia level is (15 ± 3.366 mg\dl ) and the high TSB level was reported among male gender(58.3%).The percent of preterm babies was (33.3%) of total sample .The most cases had normal weight (66.7%) at time of delivery ,mean ±SD of weight is (2698.5±693.54gram) and had no bruises or hematoma as cephalohematoma (89.2%).There was no blood diseases in about (72.5%) of total sample and no history of infection in (68.1%) of cases. The most frequent methods of feeding was breast feeding (39.7%). Regarding to time of appearance of jaundice, the most frequent cases were among those with age group (≤5 days )(89.7%) .The mean±SD for age of neonate at time of admission is (6.2±3.6 day).
 Blood group incompatibility(ABO incompatibility) was found in (60.8%) of cases with TSB level ≤18 mg/dl and (11.3%) of cases of TSB level <18 mg\dl . While Rhesus incompatibility(Rh incompatibility) was found in (13.2%) of cases with TSB level ≤18 mg/dl .
 Conclusion: This study highlights a prevalence of 9.2% for neonatal jaundice in Tikrit City and identifies important risk factors such as blood group incompatibility and preterm birth. Early detection and appropriate management of neonatal jaundice are crucial to prevent potential complications and ensure optimal neonatal care.

Diagnosis of Non-Immune Hydrops Foetalis and Cystic Hygroma in a 20-Week Foetus: A Case Report

Hydrops foetalis (HF) is the excessive fluid accumulation in at least two foetal body cavities, including pleural, pericardial, and peritoneal cavities, with associated soft tissue oedema. Most cases of hydrops foetalis were due to severe erythroblastosis foetalis, secondary to Rhesus isoimmunization. However, other variants include non-immune hydrops foetalis (NIHF). Foetal cystic hygroma, which occurs due to lymphatic obstruction, is commonly associated with immune hydrops foetalis (IHF). A combination of the conditions in a foetus tends to portend an abysmal prognosis because it can lead to abortion, intrauterine foetal death (IUFD) and early neonatal death (ENND). We report a case of a 22-year-old woman with a prenatal ultrasound diagnosis of a combination of NIHF and foetal cystic hygroma at 20 weeks of gestation. Therefore, there is a need for early diagnosis of the anomalies so that early termination of pregnancy can be performed if the patient desires.

Comparison of the Frequency of Neonatal Anemia in Early Versus Delayed Cord Clamping in Babies at Term

Aim: To compare frequency of the anemia in neonates in early versus delayed umbilical cordclamping in term infants. Study design: Randomized controlled trial. Place and duration of study: Department of Obstetrics & Gynecology, Divisional Headquarters Hospital Mirpur AJK from 30th January 2021 to 29th July 2021. Methodology: The study enrolled 96infants which were delivered at term within the gestational range of 37-41 weeks (as assessed on LMP). Those infants who were born to diabetic, sepsis mother or with inborn metabolic errors, jaundice neonatorum or Rh incompatibility and PROM were excluded from the study. Then selected women were placed randomly into two equal groups i.e. Group A (early cord clamping) & Group B(delayed cord clamping) by lottery method. Respective group selection was performed through randomization. In group a neonates, early cord clamping (cord clamping within 15 seconds of birth) was done while in group B neonates, delayed cord clamping (cord clamping after 3 minutes of birth) was done. In both groups, blood sample of all infants was sent after 6 hours of birth for hematocrit level measurement and neonatal anemia was noted. Results: The mean age in years of patients in group A was calculated as 26.52±5.17 while in group B it was calculated as 27.17±3.89. The age of 80.21% patients was within 18 to 30 years and the mean gestational age was determined as 39.23±1.48 weeks. The mean gestational age in group A was 39.25±1.48 weeks and in group B was 39.21±1.49 weeks. Frequency of neonatal anemia in group A (early cord clamp) versus group B (delayed umbilical cord clamping) was 11 (22.92%) and 04 (8.33%) respectively with p-value of 0.049. Practical Implication: we recommend that delayed umbilical cord clamping should be preferred in our routine practice for prevention of neonatal anemia. Conclusion: This study concluded that the neonatal anemia is high after early cord clamping in infants at term as compared to delayed cord clamping Keywords: Cord Clamping, Delayed, Anemia.

A novel pyrosequencing strategy for RHD zygosity for predicting risk of hemolytic disease of the fetus and newborn.

The aim of this study was the development of an accurate and quantitative pyrosequence (PSQ) method for paternal RHD zygosity detection to help risk management of hemolytic disease of the fetus and newborn (HDFN). Blood samples from 96 individuals were genotyped for RHD zygosity using pyrosequencing assay. To validate the accuracy of pyrosequencing results, all the samples were then detected by the mismatch polymerase chain reaction with sequence-specific primers (PCR-SSP) method and Sanger DNA sequencing. Serological tests were performed to assess RhD phenotypes. Serological results revealed that 36 cases were RhD-positive and 60 cases were RhD-negative. The concordance rate between pyrosequencing assay and mismatch PCR-SSP assay was 94.8% (91/96). There were 5 discordant results between pyrosequencing and the mismatch PCR-SSP assay. Sanger sequencing confirmed that the pyrosequencing assay correctly assigned zygosity for the 5 samples. This DNA pyrosequencing method accurately detect RHD zygosity and will help risk management of pregnancies that are at risk of HDFN.

Prevalence of alloantibodies associated with haemolytic disease of the fetus and newborn in pregnant women at the Ekiti State University Teaching Hospital, Ado-Ekiti, Southwest Nigeria.

Haemolytic disease of the fetus and newborn (HDFN) is caused by maternal alloimmunization against red blood cell antigens, which could result in fetal anaemia, hyperbilirubinaemia, kernicterus, and death. This study was designed to determine the prevalence of alloantibodies against erythrocyte antigens in blood samples of pregnant women during the first trimester which may cause HDFN. A total of 123 consenting pregnant women attending the antenatal clinic of Ekiti state University Teaching Hospital, Ado Ekiti participated in the study which lasted three months. The participants were within the ages of 16 to 45 years old across the major ethnic group in Nigeria. ABO/Rh typing, screening and identification of red blood cell alloantibodies were carried out using standard protocols. 15 (12.2%) subjects had detectable antibodies known to cause haemolytic disease of the fetus and newborn (HDFN). The specificity of the antibodies was as follows: anti-K (5, 33%), anti-k (3, 20%), anti- Jsa (2, 13%), anti-C. (3, 20%), and anti-E (2, 13 %). Based on ethnicity, the prevalence of Kell antibodies was highly significant among the Yorubas as well as anti-C and anti-E. The observation was similar in the Igbo and Hausa groups. There is a need to determine these antibodies and monitor their titre in pregnant women to manage or prevent the morbidity and mortality associated with HDFN during routine antenatal care.

ABO/Rh incompatibility in neonatal jaundice: a tertiary hospital based cross sectional study

Background: Neonatal hyperbilirubinemia, defined as a total serum bilirubin level above 5 mg/dl (86 μmol/l). Haemolytic disease of the newborn due to blood group incompatibilities between mother and foetus is one of the commonest cause of hyperbilirubinemia in the newborn. Methods: A Hospital based cross sectional study was conducted among newborns admitted with jaundice. Results: In our study 51 cases of neonatal jaundice were due to ABO incompatibility and among them 24 were having O-A incompatibility and 27 were having O-B incompatibility. The mean serum bilirubin in patients with ABO incompatibility were higher (24.8) than those without ABO incompatibility. Conclusions: In the present study, one third of newborns with neonatal jaundice were having ABO incompatibility. The mean serum bilirubin in patients with ABO incompatibility were higher than those without ABO incompatibility. This highlights the importance of recognizing ABO Rh incompatibility in neonatal jaundice.

Evaluate of newborn with jaundice at central teaching hospital of pediatrics in Baghdad : descriptive study

Background: - Neonatal jaundice is a frequent condition at newborns, particularly in the first few days after delivery, and it has to be treated well to prevent complications that might have significant, long-lasting complications.
 Objective: - To assess the outcome of newborn jaundice at the central teaching Hospital of pediatrics in Baghdad using different modality of treatments.
 Patients and Methods: - A retrospective study is done depending on the medical data of infants have jaundice who were admitted to the neonate units of the central teaching hospital within the period of a year, from May 1st 2020 to May 1st 2021. Blood grouping and total serum bilirubin measurements were taken in each case. Phototherapy, strong phototherapy, and exchange transfusion were utilized to treat the newborn jaundice, depending on its severity.
 Results: Total neonates admitted from 1st may2020 to1st may 2021 in neonate unit were 2508 and 855 [34%] have jaundice. the male: female rati0 is [1.6:1], males 516[60.3%], females 339[39.6%]. The Physiol0gical jaundice is the often-frequent cause 285[33.3%] patients. The Prematurity seen in 171[20%] patient and the ABO incompatibility seen in 128[1.3%] and the Rh incompatibility 17[2%] patient, the sepsis found in 16[2%] case and the other causes of hyperbilirubinemia seen in 238[27.8%] patient. the Phototherapy is the most frequent kind of management used in 513[55%] and intensive phototherapy is applied for 342[40.3%] patients and just 59[7%] of patients treated with exchange transfusion particularly patients with ABO incompatibility 25 [42%] also Rh incompatibility 34 [57.6%] Good decline in TSB level and not require the exchange transfusion is 812 [95%] of patients. Majority of infants 849 [99.55%] discharge with clinical improvement and only 17 [0.3%] of infant’s patients develops kernicterus and 8 patients is dying [0.1%]
 Conclusion: Moderate to severe hyperbilirubinemia is still often treated with phototherapy. Intensive phototherapy is beneficial in lowering T.S.B levels, minimizing the need for exchange transfusions, and shortening hospital stays in patients with newborn hyperbilirubinemia.

Jaundice and its associated factors among neonates admitted to selected referral hospitals in southwest oromia, Ethiopia: Multi-center cross-sectional study

BackgroundJaundice is a common clinical problem during the first month of birth throughout the world. Mainly, it is the leading cause of neonatal morbidity and mortality in developing countries. ObjectivesThe aimed of this studied was to assess predictors of jaundice among neonates admitted to selected referral hospitals in southwest Oromia, Ethiopia, 2021. MethodsAn Institutional based cross-sectional study was implemented among 205 admitted neonates at selected referral hospitals in southwest Oromia, Ethiopia from October 05 to November 5, 2021. Jimma medical center (JMC), Wollega University referral hospital (WURH), and Ambo University Referral hospital (AURH) were selected by simple random sampling technique. A pretested structured interviewer-administered questionnaire and medical record review was used to collect data. Both binary and multivariable logistic regression analyses were performed to identify factors associated with neonatal jaundice. Logistic regression analyses were performed to identify factors associated with neonatal jaundice. Statistical Significance was declared at P-value less than 0.05 in the final model, and if the confidence interval does not include the null hypothesis value. ResultsThe prevalence of neonatal jaundice was 20.5% (95%CI: 1.74–1.85). The mean age of neonates was 8.6 ± 7.8 days. Traditional medicine use during current pregnancy (AOR: 5.62, 95%CI: 1.07, 9.52), Rh incompatibility (AOR: 0.045, 95%CI: 0.01, 0.21), gestational age (AOR: 4.61, 95%CI: 1.05, 10.3), premature rupture of membrane (AOR: 3.76, 95%CI: 1.58, 8.93) and hypertension (mother) (AOR: 3.99, 95%CI: 1.13, 14.02) were factors significantly associated with neonatal jaundice. ConclusionNeonatal jaundice was relatively higher in the current study. Traditional medicine use, Rh incompatibility, premature ruptures of membrane, hypertension, and preterm gestational age were factors associated with neonatal jaundice.

Comparison of severity and prognosis of jaundice due to Rh incompatibility and G6PD deficiency

IntroductionUndiagnosed and untreated hyperbilirubinemia in infants may result in Kernicterus Spectrum Disorder and poor prognoses. Rhesus incompatibility and glucose-6-phosphate dehydrogenase (G6PD) deficiency are among the known causes of infantile jaundice. This study was designed to define the severity and prognosis in jaundiced infants with Rh incompatibility or G6PD deficiency. MethodsA total of 144 term, 2– 14 days old jaundiced infants (bilirubin > 20 mg/dl) with Rh incompatibility(85 infant) or G6PD deficiency(59 infant) were included in this cohort study with 24-month follow-up through available sampling at Ghaem hospital between 2015 and 2022. Denver II test was used at 6, 12, 18, and 24-month ages after discharge. Infants with Rh incompatibility or G6PD deficiency were assigned into two groups of favorable and poor prognosis. Following that, the bilirubin levels of these infants were compared at the time of admission. ResultsThe bilirubin level in G6PD deficient infants with poor prognoses (37.96 ± 9.25 mg/dl) and neonates with Rh incompatibility (36.23 ± 5.08 mg/dl) almost was the same (P = 0.232). 40 babies (47%) caused by Rh incompatibility and 33 (56%) babies caused by G6PD deficiency had a poor prognosis (P = 0.465).Average bilirubin in babies with RH incompatibility with favorable prognosis is 21.8 and poor prognosis is 36.2 mg/dl. In infants with G6PD deficiency, it was 24 mg/dl with favorable prognosis and 38 mg/dl with poor prognosis (P < 0.0001). The severity of hyperbilirubinemia had a significant role in the prognosis of infants in both groups (P < 0.0001). ConclusionThe two-year prognoses of hyperbilirubinemia caused by G6PD deficiency are as poor as that of Rh incompatibility. The severity of hyperbilirubinemia had a significant role in the prognosis of infants in both groups.Exchange transfusion in cases with bilirubin < 25 mg/dl can improve the prognosis in both groups, especially in infants with Rh incompatibility.