Comparison of anti-A and anti-B isoagglutinin titers by conventional tube and column agglutination technique in O Rh-D positive mothers and their impact on neonatal outcomes.

BACKGROUND

Maternal IgG anti-A and anti-B isoagglutinin titers are key predictors of neonatal outcomes in ABO incompatibility-related hemolytic disease of the fetus and new-born (HDFN). This study aimed to compare the Column Agglutination Technique (CAT) and conventional tube technique (CTT) in measuring maternal IgG anti-A and anti-B isoagglutinin titers and assess their correlation with neonatal outcomes.

MATERIAL AND

METHODS

This prospective observational study included 125 O Rh-D positive pregnant mothers and their neonates with A, or B blood groups. Maternal antibody titers were measured using both CTT and CAT. Neonates were monitored for jaundice, serum bilirubin levels, direct antiglobulin test (DAT) results, and treatment needs. Statistical analyses compared the two methods and correlated maternal titers with neonatal outcomes.

RESULTS

Maternal anti-A titers by CTT ranged from 1 to 64, and anti-B titers from 1 to 32. By CAT, anti-A and anti-B titers ranged from 4 to 256. Median titers were significantly higher by CAT (p < 0.05). A strong positive correlation was observed between maternal titers and neonatal serum bilirubin (r = 0.45, p < 0.05). Neonates with positive DAT had higher maternal titers (p = 0.038 for CTT; p = 0.027 for CAT). Neonates with higher maternal titers required double volume exchange transfusion (DVET), while those with lower titers needed phototherapy (p = 0.007).

CONCLUSION

The CAT method is more sensitive for measuring anti- A and B isoagglutinin titers than CTT. Both methods showed strong correlation and can guide ABO-HDFN management based on available resources.