Babies born to mothers with red cell alloimmunization, which can cause hemolytic disease of the fetus and newborn (HDFN), often need specialized care after birth, even when they don’t require treatment before delivery, according to a recent study in the journal Pregnancy.
Red cell alloimmunization occurs when a pregnant woman’s immune system reacts to their baby’s blood type, producing antibodies that attack and destroy the baby’s red blood cells.
Researchers found that nearly half of newborns born to mothers with red cell alloimmunization needed intensive care after birth, highlighting the importance of delivering at hospitals with advanced neonatal units and ensuring close follow-up.
The study suggests that even with careful pregnancy management, many babies affected by their mother’s antibodies can still develop anemia and jaundice. The mother’s antibodies can stay in the baby’s system for up to six months after birth.
Read more about treatment and care of HDFN
The study looked at pregnancies in which doctors used a Doppler ultrasound to measure blood flow in the baby’s brain but where no blood transfusions were needed before birth. This special type of ultrasound helps doctors check if the unborn baby has anemia. If the blood is flowing faster than normal, it can be a sign that the baby is anemic and may need treatment before birth, such as an intrauterine blood transfusion.
Among the 40 pregnancies studied, 46% of newborns were admitted to the neonatal intensive care unit (NICU). More than half (61.5%) needed treatment for jaundice, and over a quarter (28%) required blood transfusions.
Babies whose mothers had higher antibody levels early in pregnancy were much more likely to need treatment after birth.
“Higher titers [antibody levels] at the start of pregnancy may predict which of these neonates will need treatment for hyperbilirubinemia and/or anemia postnatally,” the researchers stated.
