母婴ABO血型不合孕妇IgG抗体效价与新生儿溶血病之间的关系探讨

目的分析母婴ABO血型不合,孕妇在丈夫血型、不同年龄、孕次等因素下IgG抗体效价分布情况,以及与新生儿溶血病（hemolytic disease of newborn,HDN）的发病率之间的关系,对产前早期预防和预测做出指导。方法研究2011-03/2013-09月来作者医院进行产前检查和分娩的IgG抗体效价≥1∶64的与婴儿血型不合孕妇864例,通过对孕妇进行产前效价评价和对新生儿进行溶血病检查,确定孕妇年龄、孕次等因素对孕妇IgG抗体效价分布的影响以及HDN发生率情况。结果研究对象中,夫妇血型配对与抗体效价分布均无显著性差异（P〉0.05）;正常年龄组孕妇的IgG抗体为1∶64、1∶128和1∶256的例数显著性高于高年龄组,而IgG抗体≥1∶512的例数显著性低于高年龄组（P〈0.05）;随着孕妇孕次的增加,效价呈显著升高趋势;HDN265例,占30.67%,其中发病率随着母亲抗体效价的增加呈显著性上升（P〈0.05）;HDN的病例中,有贫血现象出现的有97例,占36.60%,与母体效价无显著性差异（P〉0.05）。结论孕妇O型者,丈夫为A型血或B型血使孕妇的效价升高概率要比丈夫为AB血型者高,但各血型配对与效价分布无统计学差异。随着孕妇年龄和孕次的增加,孕妇IgG抗体效价会增加,HDN的发生率也会随之增加。

Relationship between Maternal-fetal ABO-incompatible Maternaligg Antibody Titer and Hemolytic Disease of the Newborn

Objective To analyse the distribution of IgG antibody titer of maternal-fetal ABO incompatibility preg- nant women of different ages, pregnant inferior factor distribution of IgG antibody titer, and relation to the incidence of the hemolytic disease of newborn （HDN）, and supply guidance to prenatal prevention and prediction.Methods A total of 864 pregnant women with IgG antibody titer〉 1 ： 64 in our hospital for prenatal care and childbirth between March 2011 to September 2013 were studied.Evaluation of pregnant women potency before prenatal and hemolytic disease of the newborn were performed,distribution of factors like husband＇ blood type, maternal age, gestational inferior on maternal IgG anti- body titer and the incidence of cases of hemolytic disease of the fetus were determined.Results The distribution of the po- tency of each woman and her husband＇s ABO types had no significant difference （P〉0.05）.When maternal IgG antibodies was 1：64 and 1：128, the number of the younger age group was significantly higher than older age group,and when mater- nal IgG antibodies was 1：512, the number of the younger age group was significantly lower.With the increase of maternal gestational times,titers had significantly upward trend.A total of 265 cases （30.67%） had newborns with hemolytic dis ease, with significantly upward trend with the increases of maternal antibody titers （P〈0.05）.Among hemolytic disease of the newborn, 97 cases （36.60%） had anemia phenomena.Conclusion The probability of parents with O-A, O-B blood type matching born babies with hemolytic is higher than O-AB. Along with the increase of pregnant women ages and pregnancy time, potency of pregnant women and the incidence of hemolytic disease of the newborn will increase.