Analysis of Titer and Subtypes Antibody in ABO Incompatibility that Causes Hemolytic Disease of Fetus and Newborn

  • Sheila Nurrahmah Program Magister Ilmu Biomedik, Fakultas Kedokteran Universitas Indonesia https://orcid.org/0000-0002-3470-6736
  • Heri Wibowo Departemen Parasitologi, Fakultas Kedokteran, Universitas Indonesia https://orcid.org/0000-0001-7708-5135
  • Ria Syafitri Evi G UDD Pusat PMI, Program Magister Ilmu Biomedik, Fakultas Kedokteran Universitas Indonesia, Diploma 3 Teknisi Bank Darah Akademi Bakti Kemuliaan PMI

Abstract

Background: Hemolytic disease of the fetus and newborn (HDFN) is a type of anemia in the fetus or newborn. Clinical features of HDFN such as hepatosplenomegaly, liver failure, ascites, at birth die from heart failure to brain damage. One of the most common causes is incompatibility of blood groups such as ABO. Differences in clinical manifestations that occur in HDFN are caused by differences in antibody titers and IgG subtypes.
Objective: The aim of this study was to determine the anti-A and anti-B antibody titers and the types of immunoglobulins that affect HDFN due to ABO incompatibility.
Methods: The sample used in this study was blood and umbilical cord blood from 30 pairs of mother-babies who had different blood groups. Titration examination by tube method and IgG subtype by ELISA method were performed on maternal samples.
Results: The correlation of total bilirubin levels with maternal Anti-A and Anti-B titers are p= 0.023 and p= 0.001, in addition there are significant increase in OD of Anti-A IgG1 and Anti-B IgG1 againts elevated infant bilirubin levels.
Conclusion: IgG titers >8 causing hyperbilirubinemia, but no jaundice and IgG titers >16 causing hyperbilirubinemia to jaundice. The IgG subtype that plays a more role in causing clinical problems is IgG1.

Author Biography

Sheila Nurrahmah, Program Magister Ilmu Biomedik, Fakultas Kedokteran Universitas Indonesia

Program Magister Ilmu Biomedik, Fakultas Kedokteran Universitas Indonesia

References

Fasano RM. Hemolytic disease of the fetus and newborn in the molecular era. Semin Fetal Neonatal Med 2016; 21(1): 28-34.

Watchko JF. Common hematologic problems in the newborn nursery. Pediatr Clin North Am 2015; 62(2): 509-24.

De Haas M, Thurik FF, Koelewijn JM, Van der Schoot CE. Haemolytic disease of the fetus and newborn. Vox Sang. 2015; 109: 99-113.

Delaney M, Matthews DC. Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn. Hematology Am Soc Hematol Educ Program 2015; 2015: 146-51.

Erhabor O. Heamolytic disease of the foetus and new born due to ABO blood group incompatibility between mother and their babies in specialist hospital sokoto, Nigeria. SF Obstet Women Health J. 2018; 1(2): 1-6.

Bhat YR, Kumar CGP. Morbility of ABO haemolytic disease in the newborn. 2012; 32(2): 93-6.

Yahya N, Yuniati T, Lubis L. Characteristics of neonatal hyperbilirubinemia at west java’s top referral hospital, Indonesia. AMJ. 2017; 4(2):167-71.

Watchko JF. Common Hematologic Problem in The Newborn Nursery. Pediatr N AM. 2015; 62 (2): 509-24.

Hunt, Js, Baeck ML, Hardman JT, Tegtmeier GE, Byer W. Characterization of human erythrocyte alloantibodies by IgG subclasses and monocyte interaction. In. Ukita M, Takahashi A, Nunotani T, Kihana T, Watanabe S, Yamada N. IgG subclasses of anti-A and anti-B antibodies bound to the cord red cells in ABO incompatible pregnancies. Vox Sang. 1989; 56: 181-86.

Brouwers HA, Overbeeke MA, van Ertbruggen I, Schaasberg W, Alsbach GP, van der Heiden C, et al. What is The Best Predictor of The Severity of ABO-Haemolytic Disease of The newborn? Lancet Lond Engl. 1988 Sep 17;2(8612):641–4.

Bakkeheim E, Bergerud U, Schmidt-Melbye AC, Akkök ÇA, Liestøl K, Fugelseth D, et al. Maternal IgG anti-A and anti-B titres predict outcome in ABO-incompatibility in the neonate. Acta Paediatrica. 2009; 98: 1896-901.

Akanmu AS, Oyedeji OA, Adeyemo TA, Ogbenna AA. Estimating the risk of ABO hemolytic disease of the newborn in Lagos. J Blood Transfus. 2015; 2015: 560738.

Klein GH, Anstee D. Mollison's blood transfusion in clinical medicine. 12th ed. UK: Wiley.

Schur PH. IgG subclasses. A Historical Perspective. Monogr Allergy. 1988;23:1–11

Dharmayani D, Gatot D, Rohsiswatmo R, Tridjaja B. Serological Profile and Hemolytic Disease in Term Neonates with ABO Incompatibility. Paediatr Indones. 2009 Aug 31;49(4):219–23.

Usha KK, Sulochana PV. Detection of High Risk Pregnancies with Relation to ABO Haemolytic Disease of Newborn. Indian J Pediatr. 1998 Dec;65(6):863–5.

Ye HH, Huang HH, Wang XL, Pi YJ. Analysis of Correlation between IgG Titer of Pregnant Women and Neonatal Hemolytic Complications of Different Blood Groups. Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2017; 25(5): 1532-1536.

Bao R, Wang S, Yang Q. Clinical Study of The Relationship between Prenatal Antibody Titer and Hemolytic Disease of Newborn. Int J Clin Exp Med 2017;10(1):1637-1642.

Li P, Pang LH, Liang HF, Chen HY, Fan XJ. Maternal IgG anti-A and anti-B titer levels screening in predicting ABO hemolytic disease of the newborn: a meta-analysis. Fetal Pediatr Pathol. 2015; 34: 341–50.

Chen JY, Ling UP. Prediction of the Development of Neonatal Hyperbilirubinemia in ABO Incompatibility. Zhonghua Yi Xue Za Zhi Chin Med J Free China Ed. 1994; 53(1): 13–8.

Kaplan M, Merlob P, Regev R. Israel Guidelines for The Management of Neonatal Hyperbilirubinemia and Prevention of Kernicterus. J Perinatol Off J Calif Perinat Assoc. 2008; 28(6): 389–397.

Wu Q, Zhang Y, Liu M, Wang B, Liu S, He C. Correlation of Fc(gamma)RIIa (CD32) Polymorphism and IgG Antibody Subclasses in Hemolytic Disease of Newborn. Neonatology. 2009 ;96(1): 1–5.

Leger RM. In Vitro Cellular Assays and Other Approaches Used to Predict The Clinical Significance of Red Cell Alloantibodies: A Review. Immunohematology. 2002; 18(3): 65–70.

Published
2023-01-02
How to Cite
1.
Sheila Nurrahmah, Heri Wibowo, Ria Syafitri Evi G. Analysis of Titer and Subtypes Antibody in ABO Incompatibility that Causes Hemolytic Disease of Fetus and Newborn. Media ilmu kesehatan [Internet]. 2023Jan.2 [cited 2024Apr.30];11(1):17-2. Available from: https://ejournal.unjaya.ac.id/index.php/mik/article/view/675