The combination of several medical indicators could be more effective for diagnosing hemolytic disease of the fetus and newborn (HDFN) than antibody testing alone, according to a recently published study ahead of the SMFN Pregnancy Meeting.
HDFN results from blood type incompatibility between fetus and mother, poses significant risks during pregnancy and has been associated with fetal and neonatal death and permanent neurological damage.
What is HDFN?
Hemolytic disease of the fetus and newborn (HDFN) is an immune-mediated red blood cell (RBC) 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. Numerous antibodies to RBC antigens can be linked to HDFN, such as those from the ABO and Rh blood group systems.
In an effort to improve diagnosis in order to provide earlier treatment, researchers have employed electronic health records (EHRs) to identify HDFN cases, shedding light on a potentially effective diagnostic approach.
Learn more about HDFN testing and diagnosis
The authors conducted a study using data from 2008 to 2022, including the EHRs of pregnant patients receiving obstetrical care. This included diagnostic and procedural codes, laboratory results and clinical notes.
Specific HDFN indicators, including antibody tests, antibody titers, HDFN diagnoses, blood transfusions/intravenous immunoglobulin treatments (IVIG) and instances of jaundice/phototherapy, were extracted.
Among the 572,328 pregnancies studied, indicators for maternal positive antibody tests, abnormal titers, HDFN diagnosis, transfusions/IVIG treatments, and infant jaundice/phototherapy were successfully extracted.
The majority of confirmed cases exhibited indicators including maternal positive antibody tests, abnormal titers, and maternal/infant HDFN diagnosis. Notably, pregnancies with all five indicators demonstrated an 89% confirmation rate for HDFN.
Results showed that traditional indicators alone, such as positive antibody test results and high titers, were insufficient in identifying HDFN pregnancies, emphasizing the need for enhanced coding practices in HDFN diagnosis.
“We successfully identified HDFN patients using a combination of medical indicators extracted from structured and unstructured data that may be used in future pharmacoepidemiologic studies,” the authors wrote.
