Evaluation of the clinical course of i̇vi̇g treatment in newborns with i̇soimmune hemolytic disease according to the type of incompatibility

Introduction and Aim: One of the most common causes of pathologic indirect hyperbilirubinemia in newborns is isoimmune hemolytic anemia, which is caused by ABO or Rh incompatibility between mother and baby. In these patients, intravenous immunoglobulin given in treatment decreases the rate of bilirubin as well as decreases the maximum bilirubin levels and reduces the need for blood exchange. The aim of this study was to evaluate the clinical course of İVİG treatment according to the type of discrepancy (NI, ABO, subgroup) of newborns with İVİG and isoimmune hemolytic disease. Material and Methots: In this retrospective study, newborn patients with direct coombs positive Rh, ABO or subgroup incompatibility were included in the records of the Neonatal Intensive Care Unit of Afyon Kocatepe University between January 2010 and December 2016. Results: In 24 patients (48.98%), the type of discrepancy was ABO, of which 22 (91.67%) had A blood group and 2 (8.33%) had B blood group. 23 patients (46.94%) had Rh and 2 patients (4.08%) had a subgroup incompatibility. As the Coombs positivity increased, the number of İVİG administration increased. The ratio of erythrocyte suspension or exchange therapy was higher in the Rh incompatibility group than in the ABO discrepancy group. Infants with İVİG treatment had a higher incidence of AO blood group mismatch. Again in the AO disagreement, the Coombs positivity rate was found to be higher compared to the BO controversy. Conclusion: Although the guidance for the relationship between İVİG treatment, isoimmune hemolytic anemia, and blood group is important, it is necessary to plan the studies that assess the possible relationship between blood group and ABO incompatibility in neonates.