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2023, Number 2

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Acta Pediatr Mex 2023; 44 (2)

Clinical and epidemiological profile of patients with hemolytic anemia of the newborn treated in a university hospital, Medellin, Colombia, 2014-2018

Roldán-Isaza M, Vergara-Yánez D, Hernández-Martínez A, Morales-Quintero N, Rodríguez-Gázquez MÁ, Martínez-Sánchez LM
Full text How to cite this article

Language: Spanish
References: 31
Page: 109-119
PDF size: 247.12 Kb.


Key words:

Infant, Newborn, Anemia, Hemolytic, Rh Isoimmunization, Erythroblastosis, Fetal, Hydrops Fetalis.

ABSTRACT

Background: Hemolytic disease of the newborn (HDN) refers to the perinatal effects of fetal maternal erythrocyte isoimmunization that leads to an immune reaction allowing lysis of these cells.
Objective: To describe the clinical and epidemiological profile of patients with HDN treated in a university hospital during the 2014-2018 period.
Materials and methods: Observational, descriptive, retrospective, cross-sectional study that included neonates with EHRN and their mothers. A non-probabilistic sampling of consecutive cases was carried out.
Results: 216 newborns diagnosed with HDN were included, with a mean gestational age of 38.1±2.18 weeks. Blood group A predominated in the neonate with 62.5% and group O in the mother with 88.4%. Regarding the clinical presentation, 85.1% of the patients presented jaundice, 86.4% received phototherapy and only 1.4% had complications.
Conclusion: The HDN in this study shows jaundice as the most frequent sign, allowing a diagnosis generally in the first 48 hours postpartum and an effective and timely intervention. It was identified that a large part of the population required phototherapy and red blood cell transfusions for their treatment to avoid later complications.


REFERENCES

  1. Jackson ME, Baker JM. Hemolytic Disease of the Fetusand Newborn: Historical and Current State. Clin Lab Med. 2021;41(1):133-151. doi: 10.1016/j.cll.2020.10.009.

  2. Esan AJ. Hemolytic Disorders of the Newborn, CurrentMethods of Diagnosis and Treatment: A Review Study.J Hematol Blood Transfus Disord. 2016;(3)1: 2-18. doi:10.24966/HBTD-2999/100008

  3. Yépez CS, Barrera MA, Achina LO, Juma JP. EnfermedadHemolítica del recién nacido. Rev. Sinapsis. 2017; 1(10).doi: 10.37117/s. v1i10.107

  4. Insunza A, Behnke E, Carrillo J. Enfermedad hemolíticaperinatal: manejo de la embarazada RhD negativo. RevChil Obstet Ginecol. 2011; 76(3): 188- 206.

  5. Fuenzalida J, Carvajal JA. Manejo de la embarazada conisoinmunización por anticuerpos irregulares. Rev ChilObstet Ginecol. 2014; 79(4): 315 – 322

  6. Rets A, Clayton AL, Christensen RD, Agarwal AM. Moleculardiagnostic update in hereditary hemolytic anemiaand neonatalhyperbilirubinemia. Int J Lab Hematol. 2019;41(1):95-101. doi: 10.1111/ijlh.13014

  7. Da Costa L. Anémies hémolytiques du nouveau-né. EMC(Elsevier Masson SAS, Paris), Pédiatrie, 4-002-R-40, 011.

  8. Ree IMC, Smits-Wintjens VEHJ, Van der Bom JG, VanKlink JMM, Oepkes D, Lopriore E. Neonatal managementand outcome in alloimmune hemolytic disease.Expert Rev Hematol 2017; 10(7):607-16. doi:10.1080/17474086.2017.1331124

  9. Li S, Mo C, Huang L, Shi X, Luo G, Ji Y, Fang Q. Hemolyticdisease of the fetus and newborn due to alloanti-M: threeChinese case reports and a review of the literature. Transfusion.2019;59(1):385-395. doi:10.1111/trf.15054

  10. Pegoraro V, Urbinati D, Visser GHA, Di Renzo GC, ZipurskyA, Stotler BA, et al. Hemolytic disease of the fetus and newborndue to Rh(D) incompatibility: A preventable diseasethat still produces significant morbidity and mortality inchildren. PLoS ONE. 2020;15(7): e0235807. Doi: 10.1371/journal.pone.0235807

  11. Vizueta-Chávez CA, López Silva BO, Balon-Benavides JE,Zambrano-Bonilla RH. Incompatibilidad Rh en el embarazo.Dominio de las Cienc. 2017. 3(4): 32-46. Doi: 10.23857/dc.v3i4

  12. Webb J, Delaney M. Red Blood Cell Alloimmunization in thePregnant Patient. Transfus. Med. Rev. 2018; 32: 213–219.Doi: 10.1016/j.tmrv.2018.07.002

  13. López-Catzín J, Bolado-García P, Gamboa-López G, Medina-Escobedo C, Cambranes-Catzim L. Disminución de transfusionesen prematuros con anemia tratados con Eritropoyetina.Rev Med Inst Mex Seguro Soc. 2016;54(5):576-80

  14. Ohls RK, Christensen RD, Kamath-Rayne BD, RosenbergA, Wiedmeier SE, Roohi M, et al. A Randomized, Masked,Placebo Controlled Study of Darbepoetin Alfa in PretermInfants. Pediatrics 2013; 132(1): e119-e127. doi: 10.1542/peds.2013-0143.

  15. American Academy of Pediatrics Subcommittee on Hyperbilirubinemia.Management of Hyperbilirubinemia in theNewborn Infant 35 or More Weeks of Gestation. Pediatrics.200; 114 (1) 297-316; DOI: https://doi.org/10.1542/peds.114.1.297

  16. Gudlaugsson B, Hjartardottir H, Svansdottir G, GudmundsdottirG, Kjartansson S, Jonsson T, et al. Rhesus D alloimmunizationin pregnancy from 1996 to 2015 in Iceland: anation-wide population study prior to routine antenatalanti-D prophylaxis. Transfusion. 2020;60(1):175-83. doi:10.1111/trf.15635.

  17. Villegas D, Duran R, Davila AA, Lopez, MR, Cortina L, VilarM, et al. Enfermedad hemolítica del recién nacido por incompatibilidadABO. Rev cubana Pediatr. 2007; 79 (4): 1-6.Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0034 75312007000400002&lng=es

  18. Izetbegovic S. Occurrence of ABO And RhD Incompatibilitywith Rh Negative Mothers. Mater Sociomed. 2013;25(4):255-8. doi: 10.5455/msm.2013.25.255-258

  19. Pan J, Zhan C, Yuan T, Chen X, Ni Y, Shen Y, et al. Intravenousimmunoglobulin G in the treatment of ABO hemolytic diseaseof the newborn during the early neonatal period at atertiary academic hospital: a retrospective study. J Perinatol.

  20. 2021; 41(6):1397-1402. doi: 10.1038/s41372-021-00963-520. Jerković M, Šumanovic D, Brzica J, Gruica T. The Incidenceand Effects of Alloimmunization in Pregnancy Duringthe Period 2000 - 2013. Geburtshilfe Frauenheilkd. 2017;77(7):780-785. doi: 10.1055/s-0043-109867

  21. Ree IMC, van 't Oever RM, Jansen L, Lopriore E, de HaasM, van Klink JMM. School performance and behavioralfunctioning in children after intrauterine transfusionsfor hemolytic disease of the fetus and newborn. EarlyHum Dev. 2021; 157:105381. doi: 10.1016/j.earlhumdev.2021.105381

  22. Tewari VV, Kumar A, Singhal A, Pillai N, Prakash A, VargheseJ, et al. Evaluation of Rh-Hemolytic Disease in Neonatesand Management with Early Intensive Phototherapy in theNeonatal Intensive Care Unit. J Trop Pediatr. 2020;66(1):75-84. doi: 10.1093/tropej/fmz033.

  23. Zwiers C, Koelewijn JM, Vermij L, van Sambeeck J, OepkesD, de Haas M, et al. ABO incompatibility and RhIG immunoprophylaxisprotect against non-D alloimmunizationby pregnancy. Transfusion. 2018; 58(7):1611-1617. doi:10.1111/trf.14606

  24. Routray SS, Behera R, Mallick B, Acharya D, Sahoo JP,Kanungo et al. The Spectrum of Hemolytic Disease ofthe Newborn: Evaluating the Etiology of UnconjugatedHyperbilirubinemia Among Neonates Pertinent to ImmunohematologicalWorkup. Cureus. 2021; 13(8): e16940.doi: 10.7759/cureus.16940

  25. Vallejo Lewis V. Impacto en el diagnóstico temprano dela enfermedad hemolítica del recién nacido en neonatosmayores de 2kg mediante el tamizaje de las bilirrubinas pormétodo transcutáneo. Pediátr.2018; 47(1): 20-31

  26. Raguz MJ, Prce Z, Bjelanovic V, Bjelanovic I, Dzida S, MabicM. 20 Years of Follow-up Alloimmunization and HemolyticDisease in Newborn: ¿Has Anything Changed in the FieldOver the Years? Klin Padiatr. 2020; 232(6):314-320. doi:10.1055/a-1248-2329

  27. Shin KH, Lee HJ, Song D, Lee SM, Kim IS, Kim H, et al.Characteristics of Bilirubin According to the Results ofthe Direct Antiglobulin Test and Its Impact in HemolyticDisease of the Newborn. Lab Med. 2019;50(2):138-144.doi: 10.1093/labmed/lmy050.

  28. Schutzman DL, Sekhon R, Hundalani S. Hour-SpecificBilirubin Nomogram in Infants with ABO Incompatibilityand Direct Coombs-Positive Results. Arch Pediatr AdolescMed. 2010;164(12):1158–1164. doi:10.1001/archpediatrics.2010.242

  29. Slootweg YM, Lindenburg IT, Koelewijn JM, Van KampIL, Oepkes D, De Haas M. Predicting anti-Kell-mediatedhemolytic disease of the fetus and newborn: diagnosticaccuracy of laboratory management. Am J ObstetGynecol. 2018;219(4): 393.e1-393.e8. doi: 10.1016/j.ajog.2018.07.020

  30. Ree IMC, Lopriore E, Zwiers C, Böhringer S, Janssen MWM,Oepkes D, et al. Suppression of compensatory erythropoiesisin hemolytic disease of the fetus and newborn dueto intrauterine transfusions. Am J Obstet Gynecol. 2020;223(1): 119.e1-119.e10. doi: 10.1016/j.ajog.2020.01.028

  31. Sainio S, Nupponen I, Kuosmanen M, Aitokallio-TallbergA, Ekholm E, Halmesmäki E, et al. Diagnosis and treatmentof severe hemolytic disease of the fetus andnewborn: a 10-year nationwide retrospective study.Acta Obstet Gynecol Scand. 2015; 94(4):383-90. doi:10.1111/aogs.12590




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Acta Pediatr Mex. 2023;44