[Serological Characteristics of Fetal and Neonatal Hemolytic Disease Caused by Maternal Unexpected Antibodies].

OBJECTIVE

By retrospectively analyzing the unexpected antibody screening results in maternal blood, to investigate the patterns of occurrence and distribution characteristics of maternal unexpected antibodies, as well as the nature and serological features of antibodies causing hemolytic disease of the fetus and newborn.

METHODS

This study enrolled a cohort of 25 780 pregnant women who underwent examination at Shandong Maternal and Child Health Hospital between January 2023 and December 2024. Unexpected antibody screening was performed on the pregnant participants using the gel microcolumn agglutination technique. Specimens testing positive for antibodies were further identified for antibody specificity. The characteristics of fetal alloimmune hemolytic disease caused by unexpected antibodies, the frequency of intrauterine transfusions, and the incidence of hemolytic disease of the newborn were analyzed.

RESULTS

Among 25 780 tested pregnant women, 105 cases were positive for unexpected antibody screening. Among them, 78 cases completed antibody identification, including 19 cases of first pregnancy and 59 cases of multiple pregnancies.There were 71 cases (91.0%) of allo.specific antibodies, mainly from the Rh blood group system (53.5%), followed by the MNS blood group system antibodies (33.8%), Lewis blood group system antibodies accounted for 8.5%; Lewis+Diego blood group system antibodies (1.4%), Lewis+Rh blood group system antibodies (1.4%) and Duffy blood group system antibodies (1.4%) were rare. Among specific antibodies, anti.M antibody was the most common (33.8%), followed by anti.E antibody (26.8%). The anti.E antibody of the Rh blood group system is the main antibody causing non.ABO hemolytic disease of the newborn, and it is more common in patients with multiple pregnancies. Anti.D antibody is the main cause of intrauterine fetal anemia. Timely implementation of intrauterine transfusion (IUT) can significantly improve fetal hemoglobin (Hb), hematocrit (Hct), and peak systolic velocity of the middle cerebral artery (MCA.PSV), effectively improving neonatal survival rate.

CONCLUSION

During the perinatal period, unexpected antibody screening should be actively carried out to timely detect the presence of unexpected antibodies, master the serological characteristics of unexpected antibodies in pregnant and lying.in women in the region, so as to ensure clinical safe blood transfusion and effectively prevent the occurrence of fetal and neonatal hemolytic diseases.