Clinical study of the relationship between prenatal antibody titer and hemolytic disease of newborn

Authors: Ruiling Bao, Shan Wang, Qingfeng Yang

Departments of 1Transfusion, 2Clinical, Xinxiang Central Hospital, Xinxiang 453000, Henan, China

Published January 30, 2017 , Int J Clin Exp Med 2017;10(1):1637-1642

OBJECTIVE: To investigate the association between prenatal blood group antibody titer and HDN to
provide a theoretical basis for the detection, prevention, and treatment of HDN in clinical practices.

CONCLUSIONS:

Sixty cases showed fetal-maternal blood group incompatibility (ABO/HDN), suggesting a

significant positive correlation between mother blood group antibodies and fetal cord blood
bilirubin > 80 μmol/L.

Rh blood group incompatibility, anti-E positive, anti-D positive, anti-A/B IgG titer ≥ 64 as risk
factors for HDN.

Prenatal blood group antibodies test can predict the relationship between blood group antibody
titer and HDN by tracking anti-A/B antibody titers, and thereby prevent the occurrence of fetal
RH-HDN.

*Format of the Article

The title and the abstract is appropriate and informative. It gives a preview on what the study is all
about. The researcher also stated their purpose and objectibe clearly. Proper citation is also observed
and relatability of the researchers to the study is unquestionable.

*serological testing

-the tests performed for the studies are appropriate. However, limitations and sensitivity of the tests
were not mentioned so the validity of the results is not clear. Although the serological tests mentioned
are sensitive for detection of antibodies, the predictive value for hdn is variable. For example, DAT has
only 20-40% sensitivity for ABO incompatibility unlike in RH alloimmunization (Romano, etal). Also,
some tests is not discussed and the some procedures were omitted.

*risk factors

The researchers included this part to establish the relationship of Antibody titrr to HDN. It is good that
the researchers only mentioned the most common risk of HDN as it is not their main concern. However,
they could have also included the possibility of antibodies against other blood groups which may cause
HDN. The result obtained under this point is quite contradicting as ABO type is not a risk group whereas
Anti-A/B is.
*Relationship between the Antibody titer and Indirect bilirubin level

This part is also a good point to study however it could be omitted in this study as it does not directly
answer nor contribute to the objective of the study. This study aims to establish whether there is a
significant relationship between antibody titer and risk of HDN. They could have included or expanded
more on the class and source of the antibody and alloantibodies of weak D women.

*Conclusions

It is well written and concluded. The author is objective and direct in summing up the results.