EARLY PREDICTION OF HEMOLYTIC DISEASE OF THE NEWBORN BASED ON CLINICAL INDICATORS
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Hemolytic disease of the newborn (HDN) is an immune-mediated condition caused by maternal alloantibodies against fetal red blood cell antigens, most commonly involving the Rh and ABO blood group systems. Early identification of neonates at risk is crucial to prevent severe anemia, hyperbilirubinemia, kernicterus, and perinatal mortality. This article reviews and synthesizes current evidence on early clinical and laboratory indicators predictive of HDN, including maternal blood group status, direct antiglobulin test (DAT) positivity, reticulocyte percentage (RET%), lactate dehydrogenase (LDH), γ-glutamyltransferase (γ-GT), hemoglobin levels, and early-onset jaundice. Evidence suggests that combined laboratory predictors improve diagnostic accuracy compared to single markers. Early screening strategies integrating maternal risk assessment and neonatal biochemical indicators can significantly enhance timely diagnosis and intervention.
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1.Ajmani, P. S. (2020). Hemolytic disease of the newborn. In Immunohematology. https://doi.org/10.1007/978-981-15-8435-0_8
2.American Academy of Pediatrics Subcommittee on Hyperbilirubinemia. (2004). Management of hyperbilirubinemia in the newborn infant ≥35 weeks of gestation. Pediatrics, 114(1), 297–316. https://doi.org/10.1542/peds.114.1.297
3.Bhutani, V. K., Johnson, L. H., & Sivieri, E. M. (1999). Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy term and near-term newborns. Pediatrics, 103(1), 6-14. https://doi.org/10.1542/peds.103.1.6
4.Bowman, J. M. (1988). The prevention of Rh immunization. Transfusion Medicine Reviews, 2(3), 129–150. https://doi.org/10.1016/S0887-7963(88)70003-7
5.Christensen, R. D., & Yaish, H. M. (2018). Hemolytic disease of the fetus and newborn: Modern practice and future investigations. Neonatology, 113(4), 330-337. https://doi.org/10.1159/000487306
6.Downes, K. A., & Sarode, R. (2006). Hemolytic disease of the fetus and newborn caused by ABO, rhesus, and other blood group alloantibodies. In Transfusion Medicine and Hemostasis. https://doi.org/10.1017/CBO9780511526978.005
7.Frecus, C., Husaru, I., Ungureanu, A., & Hangan, T. (2016). Hemolytic disease by isoimmunization in Rh and ABO systems in newborns: A clinical study. Gineco.eu, 12(4). https://doi.org/10.18643/GIEU.2016.172
8.Gottstein, R., & Cooke, R. W. (2003). Systematic review of intravenous immunoglobulin in haemolytic disease of the newborn. Archives of Disease in Childhood - Fetal and Neonatal Edition, 88(1), F6-F10. https://doi.org/10.1136/fn.88.1.F6
9.Jalali, S. Z., Mahdipour, S., Asgarzad, R., & Saadat, F. (2024). Effect of intravenous immunoglobulin on the management of Rh- and ABO-mediated hemolytic disease of the newborn. Hematology, Transfusion and Cell Therapy, 46(2). https://doi.org/10.1016/j.htct.2024.03.002
10.Krog, G. R., Donneborg, M. L., Hansen, B. M., et al. (2021). Prediction of ABO hemolytic disease of the newborn using pre- and perinatal quantification of maternal anti-A/anti-B IgG titer. Pediatric Research, 90, 134-140. https://doi.org/10.1038/S41390-020-01232-5
11.Moise, K. J., Jr. (2008). Management of rhesus alloimmunization in pregnancy. Obstetrics & Gynecology, 112(1), 164-176. https://doi.org/10.1097/AOG.0b013e31817d453c
12.Murray, N. A., & Roberts, I. A. G. (2007). Haemolytic disease of the newborn. Archives of Disease in Childhood - Fetal and Neonatal Edition, 92(2), F83-F88. https://doi.org/10.1136/adc.2005.076794
13.Myle, A. K., & Al-Khattabi, G. H. (2021). Hemolytic disease of the newborn: A review of current trends and prospects. Pediatric Health, Medicine and Therapeutics, 12, 491-498. https://doi.org/10.2147/PHMT.S327032
14.Mutiawati, V. K. (2018). Hemolytic disease of the newborn. Jurnal Kedokteran Syiah Kuala, 18(2). https://doi.org/10.24815/JKS.V18I2.18001
15.Rao, L. B., Ahmed, Z., & Ozgonenel, B. (2012). The clinical spectrum of ABO incompatibility and hemolytic disease in the newborn. Blood, 120(21), 1182. https://doi.org/10.1182/BLOOD.V120.21.1182.1182
16.Routray, S. S., Sahoo, J., Behera, R., Acharya, D., & Kanungo, G. N. (2020). An unusual case of hemolytic disease of newborn due to ABO and Rh isoimmunization. Cureus, 12(12), e12121. https://doi.org/10.7759/CUREUS.12121
17.Wu, H., Li, R., Wei, H., Zhu, W., & Xing, Y. (2024). Clinical characteristics and prognosis of hemolytic disease of the newborn caused by irregular antibodies: A 13-year retrospective analysis. Children, 11(12), 1409. https://doi.org/10.3390/children11121409
18.Zipursky, A., & Israels, L. G. (1967). The pathogenesis and prevention of Rh immunization. Canadian Medical Association Journal, 97(21), 1245-1257. https://doi.org/10.1503/cmaj.97.21.1245.