Infants who have been diagnosed with hemolytic disease of the fetus and newborn (HDFN) may experience developmental delays due to the disease.
Throughout the first 12 months of life, HDFN-affected babies will likely be monitored and screened by their doctors to track their progress and identify any delays in achieving their developmental milestones. Early detection and intervention are essential to ensure the best long-term outcomes.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell disorder that occurs when a baby’s RBCs break down quickly, which is called hemolysis. HDFN is caused by a mismatch between a mother’s and her baby’s blood type (A, B, AB, or O) or Rhesus (Rh) factor (Rh-positive or Rh-negative) during pregnancy.
How can HDFN cause developmental delays?
Anemia is common in infants with HDFN, and if it is severe, it can put the fetus at risk of a reduced or interrupted delivery of oxygen to the brain. This can lead to brain lesions and abnormalities that can stunt the baby’s development.
The most severe complication of HDFN in newborns is kernicterus, which is the result of untreated jaundice. Bilirubin levels in the blood reach dangerous levels and cross the blood-brain barrier, leaving deposits of bilirubin in the brain causing neurological damage and sometimes, death.
With early and effective treatment, a full recovery is possible, but in some cases, it can lead to permanent brain damage. Consequences may include cerebral palsy, seizures, dental problems, hearing loss, vision loss and developmental delays.
Birth or medical trauma can also have an affect on a baby’s development, with delays reported in emotional, social and behavioral aspects of development.
Learn more about HDFN symptoms and risks
What developmental delays can occur due to HDFN?
Babies who have been diagnosed with HDFN during pregnancy or following delivery are closely monitored during the first 12 months for any potential consequences of HDFN. Key development milestones are tracked according to a standard development schedule. If any delays according to the appropriate age range are detected, referrals to pediatric specialists will ensure the best care. Developmental delays may occur in any of the following areas.
Gross motor skills: refers to the large muscles in arms, legs and torso and physical movements such as holding their head, rolling, pushing up on arms and eventually sitting.
Fine motor skills: refers to use of the hands and upper extremities to reach, grasp and manipulate objects.
Language: when a baby reacts to sounds, cries to express a need, listens and recognizes voices, gurgles, imitates sounds, babbles and coos.
Social interaction: relates to a baby’s emotional and social development, ranging from becoming calm when picked up or soothed and smiling,
Cognitive function: relates to a baby learning to focus on objects or people’s faces, see colors, react to their environment, recognize familiar faces, playing peek-a-boo and waving goodbye
You can be proactive about monitoring your baby’s progress by referring to the U.S. Center for Disease Control’s Milestone Tracker and keeping a detailed milestone diary. Your pediatrician will regularly screen your baby and may recommend the intervention of neurologists, audiologists or physical therapists.
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