To Study the Prevalence of ABO Incompatibility in O Blood Group Mothers and Assessment of IgG Subclasses (IgG1 And IgG3) in them and Its Correlation with Occurrence and Severity of ABO Hemolytic Disease of Newborn (ABO-HDN) in a Tertiary Health Care Centre in South India

Reshma Kurian, (2020) To Study the Prevalence of ABO Incompatibility in O Blood Group Mothers and Assessment of IgG Subclasses (IgG1 And IgG3) in them and Its Correlation with Occurrence and Severity of ABO Hemolytic Disease of Newborn (ABO-HDN) in a Tertiary Health Care Centre in South India. Masters thesis, Christian Medical College, Vellore.

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Abstract

INTRODUCTION: ABO Hemolytic disease of the newborn (ABO HDN) is an immune reaction that occurs most commonly in newborns of A, B or AB blood group born to mothers of O blood group. Following the introduction of Rh immunoprophylaxis, the prevalence of Rh haemolytic disease has come down drastically and now ABO-HDN is emerging as the most common cause of HDN in the developed countries. ABO HDN occurs due to transplacental transfer of maternal anti-A and anti-B IgG antibodies leading to immune haemolysis of fetal erythrocytes. IgG has 4 subtypes – IgG1, IgG2, IgG3 and IgG4, of which IgG1 and IgG3 are effectively transported across placenta via an Fc receptor. There is very limited literature on the prevalence and factors that impact on ABOHDN from India. Against the background of extremely variable health care facilities in our country, we thought it is critical to study factors that may predict the severity of ABO-HDN in mothers with O blood group. Early identification, diagnosis and intervention can reduce morbidity and mortality due to ABO hemolytic disease of newborn. OBJECTIVES: 1. To study prevalence of ABO incompatible pregnancies in O blood group mothers. 2. To study the correlation of maternal IgG anti-A and anti-B titers and IgG1/IgG3 subclasses with occurrence of ABO-HDN. METHODS: A total of 575 mothers with O blood group and a negative antibody screen were recruited for the study. Venous samples were collected after obtaining consent from the 203 mothers who delivered babies with either A or B blood group. Maternal anti -A and anti- B titers and IgG1 and IgG3 subtyping were performed in the collected samples. Babies were assessed by the neonatology team for the presence or absence of HDN using criteria as per the international guidelines. Pearson and Fischer’s exact chi square was used for comparison of categorical data. Univariate and binary logistic regression analysis was used for comparing the categorical data and to calculate the odds ratio. P value < 0.05 was considered significant. RESULTS: The prevalence of ABO incompatible pregnancies was estimated to be 35.3% in O blood group mothers and among them 37.4% cases developed ABO-HDN. There was an independent association between maternal IgG titer levels of ≥ 64 and presence of IgG1/IgG3 subclasses with the occurrence of ABO-HDN (p value < 0.001). Analysis of IgG1 and IgG3 subclasses showed statistically significant association with HDN at titers of 16, 32 and 64 (p value <0.05, <0.001and < 0.001 respectively)

Item Type: Thesis (Masters)
Additional Information: 201713358
Uncontrolled Keywords: Prevalence, ABO Incompatibility, O Blood Group Mothers, Assessment of IgG Subclasses (IgG1 And IgG3), Correlation with Occurrence, Severity of ABO Hemolytic Disease of Newborn (ABO-HDN), Tertiary Health Care Centre, South India.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 18:21
Last Modified: 29 Jan 2021 18:21
URI: http://repository-tnmgrmu.ac.in/id/eprint/13436

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