Babies who have ABO hemolytic disease of the fetus and newborn (HDFN), a condition where a baby’s red blood cells are destroyed by antibodies from the mother due to a blood type incompatibility, should be checked for signs of jaundice two to three times during the first day after birth, according to a recent study in the journal BMC Pediatrics.
When a mother’s antibodies attack her baby’s red blood cells because their blood types don’t match, the baby can develop jaundice, which causes yellowing of the skin and the whites of the eyes. It is due to the build-up of a yellow pigment called bilirubin in their blood, which can be dangerous.
Traditionally, babies with this condition are treated with phototherapy, a special light that helps break down the bilirubin in their blood. Doctors may also use exchange transfusion, where the baby’s blood is replaced with healthy blood to remove excess bilirubin. Another option is IVIG (intravenous immunoglobulin) — a drip containing antibodies from healthy donors that can help calm the immune reaction. However, doctors still debate when IVIG should be used.
The study, conducted in China, found that babies admitted to the hospital within 48 hours of birth benefited most from IVIG—their bilirubin levels dropped about three times faster than in those who did not receive it. “But it is not very helpful for neonates with ABO HDN with admission age greater than 48 hours,” the researchers said.
Read more about treatment and care for HDFN
In this study, researchers at West China Second University Hospital reviewed data from 948 newborns with ABO HDN. Of these, 143 received IVIG in addition to phototherapy, and 805 received phototherapy alone.
The study found no side effects from IVIG in any of the infants, whether they received IVIG within the first two days after birth or later.
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