YANG Li 1LIU Wei 1ZHAO Yuan 1LI Daihong1
作者信息
- 1. Department of blood transfusion,Tianjin First Central Hospital,Tianjin 300192,China
- 折叠
摘要
Abstract
Objective To investigate the correlation between maternal parity and ABO hemolytic disease of the fetus and newborn(ABO-HDFN).Methods A total of 244 neonates diagnosed with ABO-HDFN who were admitted to the neona-tology department of of our hospital from January 2021 to December 2024 were selected as the research subjects.According to maternal parity,the neonates were divided into the first-(n=139),second-(n=79),and third-parity group(n=26).Statistical analyses were performed on the maternal IgG anti-A(B)antibody titer,results of the three hemolysis tests,he-molysis-related indicators,and treatment regimens among the three groups.Binary logistic multivariate regression analysis was applied to identify the risk factors for intravenous immunoglobulin(IVIG)therapy in neonates.Results The propor-tions of mothers with IgG anti-A(B)titers＜64 and ≥64 in each group were as follows:first parity group:86.33％vs 13.67％;second parity group:70.89％vs 29.11％;third parity group:53.85％vs 46.15％.Compared with the first parity group,both the second and third parity group showed statistically significant differences(P12=0.005,P13＜0.001),while no statistically significant difference was observed between the second and the third parity group(P23=0.110).The positive rates of direct Coombs test in the first,second and third parity groups were 19.42％,34.18％and 42.31％,respectively.Compared with the first parity group,the second and third parity group showed statistically significant differences(P12=0.015,P13=0.011),whereas the difference between the second and third parity group was not statistically significant(P23=0.454).The absolute values of reticulocytes(RET#)(× 109/L)in the first,second and third parity groups were 197.02±66.16,225.69±67.42 and 227.74±64.03,the reticulocyte percentages(RET％)were 4.80±1.83,5.81±2.07 and 5.90±1.84,and the immature reticulocyte fractions(IRF％)were 38.35±8.06,40.76±6.63 and 43.25±5.86,respec-tively.There were statistically significant differences in RET#and RET％between the first and second parity group(RET#:P12=0.002;RET％:P12＜0.001),but no statistically significant difference in IRF％(P12=0.022).There were statistical-ly significant differences in RET％and IRF％between the first and third parity group(RET％:P13=0.008;IRF％:P13=0.002),while no statistically significant difference was found in RET#(P13=0.031).No statistically significant differ-ences were observed between the second and the third parity group(RET#:P23=0.891,RET％:P23=0.825,IRF％:P23=0.139).The proportions of neonatal patients with normal hemoglobin(HGB)levels(＞144 g/L),mild anemia(120-144 g/L)and moderate anemia(90-120 g/L)were 72.66％,25.90％and 1.44％in the first parity group;51.90％,35.44％and 12.66％in the second parity group;and 46.15％,38.46％and 15.38％in the third parity group.Compared with the first parity group,the second and third parity group showed statistically significant differences(P12=0.001,P13=0.009).However,there was no statistically significant difference between the second and third parity group(P23=0.594).The pro-portions of neonatal patients receiving phototherapy alone and phototherapy combined with IVIG treatment in the three groups were as follows:first parity group:84.17％and 15.83％;second parity group:63.29％and 36.71％;third parity group:61.54％and 38.46％.Compared with the first parity group,the second and third parity group showed statistically signifi-cant differences(P12＜0.001,P13=0.007),while no statistically significant difference was detected between the second and third parity group(P23=0.873).Conclusion When the maternal parity is ≥ 2,the titers of maternal IgG anti-A(B)antibody increase,and the neonates present with elevated positive rate of direct Coombs test and reticulocyte count,along with changes in the degree of anemia and clinical treatment strategies.Positive direct Coombs test and low 24-hour hemoglo-bin level are the risk factors for clinical administration of IVIG therapy.关键词
妊娠胎次/抗体效价/直接库姆实验/IVIG治疗Key words
parity/antibody titer/direct Coombs test/IVIG therapy分类
医药卫生
