Abstract

A Comparative Study of Cord Blood Bilirubin Levels and Duration of ICU Stay in Maternal ABO and Rh-D Antibody Mediated Haemolytic Disease of Newborn

Author(s): Sajith Vilambil 1 , Meena Dharmadas2 , Shaiji Panthiyil Shahulhameed3 , Kumari Krishnakumariamma Chakrapani Usha4 , Chitra James5 , Anjaly Padmavilas Sasikala6 , Soonam John7 , Vineeth Rajagopal8

BACKGROUND Lifespan of fetal or neonatal red cells is decreased by placental transfer of maternally produced IgG antibodies in immune mediated Haemolytic Disease of Fetus and Newborn (HDFN). We wanted to compare cord blood bilirubin levels and the duration of ICU stay in maternal ABO and RH-D antibody mediated haemolytic disease of fetus and newborn. METHODS This research work was designed as a cross sectional study. 154 neonates who were diagnosed to have HDFN were studied in the Department of Transfusion Medicine and Pediatrics, Government Medical College, Trivandrum, Kerala. 5 mL umbilical cord blood was collected at the time of delivery. The collected sample was used for analyzing bilirubin levels. Duration of ICU stay of the neonates was recorded. SPSS version 16 was used for statistical analysis. RESULTS The mean cord blood bilirubin levels in ABO haemolytic disease was 5.16 ± 1.91. The mean cord blood bilirubin level in Rh-D haemolytic disease was 4.15 ± 1.10. In infants with ABO haemolytic disease, 55 (50 %) stayed in ICU for 5 days. Remaining 50 % stayed in ICU ranging from 6 - 14 days. Among infants with RhD haemolytic disease 22 (50 %) stayed in ICU for 5 days. Remaining 50 % had stayed in ICU for 6 - 15 days. Mean duration of stay of infants with ABO haemolytic disease in ICU was 7.2 ± 2.9 days. The mean duration of stay of infants with RhD haemolytic disease in ICU was 6.8 ± 2.7 days. Mean values of cord blood bilirubin levels in both categories of haemolytic disease (ABO and Rh-D HDFN) were compared using independent t test. Significant difference was observed with a p value of 0.001. Mean values of duration of stay of neonates in both categories of haemolytic disease (ABO and Rh-D HDFN) in ICU were compared using independent t test. No significant difference was observed during the analysis. CONCLUSIONS Umbilical cord blood bilirubin levels were significantly higher in ABO haemolytic disease as compared to Rh-D haemolytic disease. Even though duration of stay in ICU was higher for neonates suffering from ABO HDFN as compared to Rh-D HDFN category, the difference was not statistically significant.