The prognostic value of AQP1 in hyperbilirubinemia related to ABO hemolytic disease of the newborn.

BACKGROUND

ABO hemolytic disease of the newborn (ABO-HDN) is a major cause of hyperbilirubinemia in neonates, often inducing significant elevation of serum bilirubin levels shortly after birth.

PURPOSE: This study aimed to assess the prognostic value of Aquaporin 1 (AQP1) for hyperbilirubinemia in ABO-HDN as reflected by the duration of phototherapy, a key clinical indicator of disease severity and treatment response.

METHODS

A retrospective cohort study was conducted, enrolling 168 neonates with ABO-HDN-related hyperbilirubinemia. Serum AQP1 expression was detected by RT-qPCR, and neonates were divided into a high-AQP1 expression group (n = 84) and a low-AQP1 expression group (n = 84) according to the median. All neonates were followed up for 7 days after the initiation of phototherapy, and a cure was defined as no total bilirubin (TBIL) rebound within 48 h after reaching the normal TBIL level. The cure rate was defined as the proportion of participants who achieved a cure within the 7‑day follow‑up period.

RESULTS

The AQP1 expression in the ABO-HDN group was significantly higher than that in the control group. Additionally, the high-AQP1 group had a longer cure time and a lower cure rate within 7 days. Spearman analysis showed that AQP1 was positively correlated with TBIL (R = 0.481, P < 0.001). Cox regression analysis confirmed that high AQP1 expression was associated with a reduced cure rate (HR = 0.623, 95%CI: 0.449-0.861, P = 0.004).

CONCLUSION

High-AQP1 expression was closely associated with prolonged treatment duration in ABO-HDN-related hyperbilirubinemia. AQP1 can serve as a potential molecular marker for prognostic assessment and individualized treatment guidance in such neonates.