ABO INCOMPATIBILITY AND NEWBORNS HYPERBILIRUBINEMIA: DESCRIPTIVE STUDY IN AL-FAYHAA TEACHING HOSPITAL, BASRAH, IRAQ

Author Name: 1. Rafid Khalaf Al-Hasani 2. Husam Jawad Al-Attar 3. Mustafa Salah Alahmed

Volume/Issue: 06/12

Country: Iraq

DOI NO.: 08.2020-25662434 DOI Link: https://doi-ds.org/doilink/06.2026-54318114/UIJIR

Affiliation:

1. M.B. Ch.B, C.A.B.P., Department of Pediatrics, Al-Fayhaa Teaching Hospital, Basrah Health Directorate, Basrah, Iraq.

ABSTRACT

ABO hemolytic disease of the newborn (ABO-HDN) is one of the most common causes of immune-mediated hemolysis during the neonatal period. It results from maternal immunoglobulin G (IgG) antibodies crossing the placenta and destroying fetal erythrocytes, often leading to neonatal jaundice and hyperbilirubinemia. Objectives: To estimate the risk of ABO hemolytic disease of the newborn in Basrah province, evaluate its clinical manifestations, and assess treatment outcomes among affected neonates. Methods: A retrospective study was conducted at the Department of Pediatrics, Al-Fayhaa Teaching Hospital, Basrah, Iraq, during 2023. Forty term neonates diagnosed with jaundice and/or anemia secondary to ABO incompatibility were included. Demographic, maternal, clinical, and laboratory data were collected from hospital records. Investigations included blood group determination, complete blood count, serum bilirubin, and direct Coombs test (DCT). Management strategies and clinical outcomes were reviewed. Results: A total of 40 neonates were included, comprising 22 (55.0%) males and 18 (45.0%) females. The mean birth weight was 3500 ± 465 g, and the mean age at admission was 4.6 ± 1.9 days. Mean initial indirect bilirubin was 21.25 ± 4.1 mg/dL, while mean hemoglobin was 13.3 ± 2.31 g/dL. Early-onset jaundice within 24 hours occurred in 6 (15.0%) neonates, and anemia was observed in 9 (22.5%). Positive DCT results were detected in 4 (10.0%) infants. Blood groups A and B were identified in 35.0% and 32.5% of neonates, respectively. Conclusion: ABO incompatibility remains an important cause of neonatal hemolytic disease; however, its clinical course is generally mild and manageable. Neonatal blood type was not significantly associated with disease severity or treatment outcomes. Early recognition, close bilirubin monitoring, and timely intervention, particularly phototherapy, are essential to prevent complications and optimize neonatal outcomes.

Key words: ABO incompatibility, Hemolytic disease of the newborn, Neonatal jaundice, Hyperbilirubinemia, Direct Coombs test.