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Published on: August 25, 2014
Comparing Neurodevelopmental Outcome among Neonates with Jaundice Due to ABO and Rh Incompatibility
Hassan Boskabadi1, Elnaz Farajirad2, Fathemeh Bagheri1,3
1Department of Pediatrics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Neonates with Rh incompatibility face higher neurodevelopmental risks than those with ABO incompatibility, even with similar bilirubin levels. Early identification and intervention are crucial for managing hyperbilirubinemia complications.
Area of Science:
- Neonatal Medicine
- Pediatric Neurology
- Immunology
Background:
- Hyperbilirubinemia in newborns is a common condition.
- Maternal-fetal ABO and Rh incompatibility are primary causes of neonatal jaundice.
- Evaluating risk factors and clinical outcomes is crucial for effective management.
Purpose of the Study:
- To determine the prevalence of predisposing factors and complications of hyperbilirubinemia.
- To compare newborns with ABO incompatibility to those with Rh incompatibility.
- To assess neurodevelopmental outcomes in infants with these conditions.
Main Methods:
- A descriptive-analytical study was conducted from 2017-2019.
- Newborns with jaundice were divided into ABO (n=83) and Rh (n=81) incompatibility groups.
- Neurodevelopmental assessment used the Denver Developmental Screening Test II (DDST-II).
Main Results:
- No significant differences in age, Apgar score, or bilirubin levels between groups.
- Infants with Rh incompatibility showed significantly higher rates of developmental delay by age three (45.8% near-normal vs. 89.1% in ABO group).
- A significant difference was found in developmental status between the ABO and Rh incompatibility groups (P < 0.05).
Conclusions:
- Rh incompatibility poses a greater neurodevelopmental risk than ABO incompatibility.
- Despite similar initial presentations, Rh-mediated hemolysis leads to more frequent moderate to severe developmental delays.
- This highlights the importance of monitoring neurodevelopmental outcomes in infants with Rh incompatibility.
Objectives:
Evaluating risk factors is essential in the context of hyperbilirubinemia and its clinical outcomes, particularly when attributed to its primary causes: maternal-fetal ABO and Rh incompatibility. This study aims to determine the prevalence rate of predisposing factors and complications of hyperbilirubinemia in newborns with ABO blood group incompatibility, compared to those with Rh incompatibility.
Materials & Methods:
This is a descriptive-analytical study. The newborns with jaundice who were referred to Ghaem Teaching Hospital affiliated to the Mashhad University of Medical Sciences, Mashhad, Iran, from 2017 to 2019, divided into two groups of ABO incompatibility (n = 83) and Rh incompatibility (n = 81). The neurodevelopmental assessment was performed by Denver Developmental Screening Test II (DDST-II). Following that, a comparison was made between these two groups.
Results:
The mean age of the ABO incompatibility group was 5.84 days and the Rh incompatibility group was 4.91 days at admission time. The mean values of bilirubin level obtained at 28.26 ± 5.9 and 30.17 ± 8.19 in newborns with ABO and Rh incompatibility (P = 0.089). No significant difference was observed between the two groups regarding age, Apgar score, bilirubin level (P > 0.05), delivery type (χ2 = 1.56; P = 0.21), and gender (χ2 = 0.403; P = 0.52). Among the study population, 45.8% and 89.1% of the infants with Rh incompatibility and with ABO incompatibility had a near-normal neurological development in the first three years of life. A significant difference was found between the two groups regarding developmental status (χ2 = 25.13; P < 0.05).
Conclusion:
Despite similar bilirubin levels and treatment approaches, neonates with Rh incompatibility experienced significantly higher rates of developmental delay compared to those with ABO incompatibility. By age three, moderate to severe delays were more frequent in the Rh group, underscoring the greater neurodevelopmental risk associated with Rh-mediated hemolysis.
