ABO haemolytic disease of the newborn: Improved prediction by novel integration of causative and protective factors in newborn and mother
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ABO haemolytic disease of the newborn : Improved prediction by novel integration of causative and protective factors in newborn and mother. / Krog, Grethe Risum; Lorenzen, Henriette; Clausen, Frederik Banch; Hansen, Anne Todsen; Donneborg, Mette Line; Dziegiel, Morten Hanefeld.
In: Vox Sanguinis, Vol. 117, No. 3, 2022, p. 415-423.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - ABO haemolytic disease of the newborn
T2 - Improved prediction by novel integration of causative and protective factors in newborn and mother
AU - Krog, Grethe Risum
AU - Lorenzen, Henriette
AU - Clausen, Frederik Banch
AU - Hansen, Anne Todsen
AU - Donneborg, Mette Line
AU - Dziegiel, Morten Hanefeld
N1 - Publisher Copyright: © 2021 International Society of Blood Transfusion
PY - 2022
Y1 - 2022
N2 - Background and Objectives: Prediction of haemolytic disease of the foetus and newborn (HDFN) caused by maternal anti-A/-B enables timely therapy, thereby preventing the development of kernicterus spectrum disorder. However, previous efforts to establish accurate prediction methods have been only modestly successful. Materials and Methods: In a case–control study, we examined 76 samples from mothers and 76 samples from their newborns; 38 with and 38 without haemolysis. The IgG subclass profile of maternal anti-A and anti-B was determined by flow cytometry. Samples from newborns were genetically analysed for the A2 subgroup, secretor and FcγRIIa receptor alleles. Results: Surprisingly, we found a correlation between the newborn secretor allele and haemolysis (p = 0.034). No correlation was found for FcγRIIa alleles. The A2 subgroup was found only in newborns without haemolysis. Unexpectedly, different reaction patterns were found for maternal anti-A and anti-B; consequently, the results were treated separately. For the prediction of haemolysis in A-newborns, the maternal IgG1 subclass determination resulted in an accuracy of 83% at birth. For B-newborns, an accuracy of 91% was achieved by the maternal IgG2 subclass determination. Conclusion: We improved the prediction of ABO-HDFN by characterizing maternal anti-A and anti-B by flow cytometry and we presented genetic traits in newborns with correlation to haemolysis. We propose a new understanding of A- and B-substances as immunogens that enhance the maternal immune response and protect the newborn, and we suggest that the development of ABO-HDFN is different when caused by maternal anti-A compared to maternal anti-B.
AB - Background and Objectives: Prediction of haemolytic disease of the foetus and newborn (HDFN) caused by maternal anti-A/-B enables timely therapy, thereby preventing the development of kernicterus spectrum disorder. However, previous efforts to establish accurate prediction methods have been only modestly successful. Materials and Methods: In a case–control study, we examined 76 samples from mothers and 76 samples from their newborns; 38 with and 38 without haemolysis. The IgG subclass profile of maternal anti-A and anti-B was determined by flow cytometry. Samples from newborns were genetically analysed for the A2 subgroup, secretor and FcγRIIa receptor alleles. Results: Surprisingly, we found a correlation between the newborn secretor allele and haemolysis (p = 0.034). No correlation was found for FcγRIIa alleles. The A2 subgroup was found only in newborns without haemolysis. Unexpectedly, different reaction patterns were found for maternal anti-A and anti-B; consequently, the results were treated separately. For the prediction of haemolysis in A-newborns, the maternal IgG1 subclass determination resulted in an accuracy of 83% at birth. For B-newborns, an accuracy of 91% was achieved by the maternal IgG2 subclass determination. Conclusion: We improved the prediction of ABO-HDFN by characterizing maternal anti-A and anti-B by flow cytometry and we presented genetic traits in newborns with correlation to haemolysis. We propose a new understanding of A- and B-substances as immunogens that enhance the maternal immune response and protect the newborn, and we suggest that the development of ABO-HDFN is different when caused by maternal anti-A compared to maternal anti-B.
KW - blood groups
KW - genotyping
KW - haemolytic disease of the foetus and newborn
KW - RBC antigens and antibodies
KW - serological testing
U2 - 10.1111/vox.13195
DO - 10.1111/vox.13195
M3 - Journal article
C2 - 34409614
AN - SCOPUS:85112762905
VL - 117
SP - 415
EP - 423
JO - Vox Sanguinis
JF - Vox Sanguinis
SN - 0042-9007
IS - 3
ER -
ID: 276854698