EFFECT OF ABO INCOMPATIBILITY ON PREGNANCY-INDUCED RH ISOIMMUNIZATION

The protective effect of ABO incompatibility between mother and fetus in respect of pregnancy-induced Rh isoimmunization has been recognized for approximately 20 years. Many have tacitly assumed that this protection was absolute and that when an infant was born with Rh hemolytic disease of the newborn, who was also ABO-incompatible with its mother, there must have been a previous ABO-compatible pregnancy in which the mother was initially sensitized. It has also been assumed that pregnancy-induced Rh isoimmunization could not occur if the father was AB and the mother O. Data are presented to show that both of these assumptions are not universally true. In a detailed study of a large number of families with pregnancy-induced Rh iso-immunization, nine families were found in which sensitization occurred and in which ABO incompatibility was present in every pregnancy. In addition, three families are documented in which pregnancy-induced Rh immunization had occurred and in which the father was AB and the mother O.