Currently, we screen for HDN/F only in newborns delivered of group O moms and Rh-Negative moms. What is the incidence of ABO-HDF/N in newborns of group A or group B mothers?

Malcolm?

Edited March 7, 201510 yr by Dansket

I think I have seen this one time in 40+ yrs. (maybe)

Phew - thanks for your confidence in me Dansket!  It may be unfounded!!!!!!!!!

 

To quote Geoff Daniels (Human Blood Groups, 2013, 3rd edition, Wiley-Blackwell),

 

"When it occurs, HDFN caused by ABO antibodies is usually in A₁ or B babies of group O mothers.  Very rarely, group B babies of A₂ mothers may be affected.  About 15% of pregnancies in women of European origin involve a group O mother with a group A or B fetus, yet ABO HDFN requiring clinical intervention is rare, although minor symptoms involving a small degree of red cell destruction may be relatively common."

 

To quote Marion Reid, Christine Lomas-Francis and Martin Olsson (The Blood Group Antigen FactsBook. 2012, 3rd edition, Academic Press),

 

For both anti-A and anti-B, "HDFN No to moderate (rarely severe).", but for anti-A,B, "HDFN No to severe.", with a footnote saying,

 

"No data to differentiate anti-A or anti-B from anti-A,B as the implicated antibody specificity in affected fetuses/infants to group O mothers in whom ABO-related HDFN is more common.  However, group O individuals (who are the only anti-A,B makers) produce more IgG antibodies against ABO antigens compared to A and B individuals.  Anti-A,B crosses the placenta more frequently than do anti-A and anti-B."

 

From the above, therefore, I think that we can safely say that clinically significant ABO HDFN in the fetus of either a group A or group B mother is very rare indeed.

In my 39+ years (I think David has me by 1 year), I have seen one instance of ABO HDN severe enough to require exchange transfusion with a non-O mom.  It was a group A mom and a group B infant and it was  at least 30 years ago.

We do screening the same - only group O or Rh neg moms.  i guess I'm the youngster here with 37 yrs...yahoo!!  I never get to say that anymore.

 

That said, we do save the cords and mom's specimen in case the clinical symptoms warrant further testing.

We do the same as Kate (the youngster amongst us)

I just have to chime in with a claim of being the youngest with 36 yrs (until all of those whippersnappers start spouting off).  I have never seen a case of ABO HDFN in a non-O mom that I can recall.

Not to be a whippersnapper, but I have also never seen a case of ABO HDFN in a non-O mom in 24 years.

Add my 37 years to never having seen a clinically significant HDN under these circumstances.  So far that's 213 years infavor of not worrying about it.  Didn't include Malcolm because he didn't contribute his years but that will probably put us over 300. 

We still do type and DAT on every newborn in our small (139 bed) hospital.  We have bigger fish to fry in blood bank to fight that battle.

Oh no, well over 500 John!!!!!!!!!!!!

 I have also never seen a case of ABO HDFN in a non group O mom which is severe enough to warrant clinical intervention in 30 years.

Edited March 25, 201510 yr by Abdulhameed Al-Attas

I have not seen a case of ABO HDFN in a non group O mom which required exchange. (50 years - started MT school in 1965)

Never seen severe ABO HDFN in my experience (12 yrs!)

OK, I'll add my 35 years. I've never seen serious HDN with a non-O mom. Actually I haven't seen HDN severe enough to require exchange transfusion in an O mom for 30 years - and those cases wouldn't have been exchanged if they had been born today.