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Newborn screening for ABO hemolytic disease.

D H Levine, H B Meyer

    Clinical Pediatrics
    |July 1, 1985
    PubMed
    Summary
    This summary is machine-generated.

    Routine screening tests are not recommended for managing ABO hemolytic disease in newborns. Current laboratory investigations, including the direct antiglobulin test and cord blood bilirubin, lack diagnostic accuracy and predictive value for disease severity.

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    Area of Science:

    • Neonatal Medicine
    • Immunology
    • Pediatric Hematology

    Background:

    • ABO hemolytic disease diagnosis and incidence remain unclear.
    • Imprecise diagnosis can lead to premature infant discharge.
    • Need for improved screening and severity indicators identified.

    Purpose of the Study:

    • Evaluate extensive cord blood screening for ABO hemolytic disease.
    • Identify potential indicators of disease severity.
    • Assess the utility of common laboratory investigations.

    Main Methods:

    • Pilot study involving 1391 cord blood specimens.
    • Tests included ABO/Rh typing, direct antiglobulin test (DAT), indirect Coombs, and bilirubin levels.
    • Analysis of DAT and bilirubin for diagnostic and predictive value.

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    Main Results:

    • 53.3% of specimens were type A, B, or AB.
    • 19.3% of A/B infants and 7% of AB infants had immune antibodies.
    • DAT was neither diagnostic nor predictive; negative in 48% with antibodies.
    • Cord blood bilirubin was not diagnostic but moderately predictive of peak levels.

    Conclusions:

    • Current data do not support routine screening tests for ABO hemolytic disease management.
    • Direct antiglobulin test is unreliable for diagnosis or severity prediction.
    • Cord blood bilirubin offers limited predictive value for peak levels.