孕妇产前IgG抗-A(B)抗原效价与新生儿高胆红素血症发生率关系探讨

目的 探讨O型血孕妇产前IgG抗-A(B)抗原效价与A(B)型血新生儿高胆红素血症发生率的关系.方法 对夫妻ABO血型不合的O型血孕妇测定IgG抗-A(B)抗原效价,对A(B)型血新生儿脐血做血清学检查,按孕妇妊娠的次数及检验结果 分组调查其高胆红素血症发生率和发病时间.结果 (1) 第一胎与第二胎以上妊娠的孕妇IgG抗-A(B)抗原效价无显著差别,脐血检验结果 差异无显著性,新生儿高胆红素血症发生率差异无显著性(P>0.05).(2) 孕妇IgG抗-A(B)抗原效价依次增高,新生儿抗体释放试验阳性率、游离抗体阳性率、高胆红素血症发生率差异均有非常显著性(P<0.01).(3) 孕妇IgG抗-A(B)抗原效价≤1∶64、抗体释放试验阳性的新生儿高胆红素血症发生率显著高于对照组的新生儿(P<0.01).(4) 孕妇IgG抗-A(B)抗原效价依次增高,新生儿在出生3d内高胆红素血症发生率差异无显著性(P>0.05).结论 妊娠次数与孕妇IgG抗-A(B)抗原效价及新生儿高胆红素血症发生率无显著关系;孕妇IgG抗-A(B)抗原效价≥1∶32时,新生儿发生高胆红素血症的危险增加;随着孕妇IgG抗-A(B)抗原效价增高,新生儿高胆红素血症发生的概率增大,但对新生儿发病时间无显著影响.

Relationship between the antigenic titer of anti-A(B) IgG in pregnant women and the incidence of hyperbilirubinemia in newborns

Objective To study the relationship between the antigenic titer of anti-A(B) IgG in pregnant women with blood-type O and the incidence of hyperbilirubinemia in newborns with blood-type A or B.Methods The antigenic titer of anti-A(B) IgG were determined in pregnant women with blood-type O whose blood type were incompatible with their mates'.Serological tests for the umbilical blood were analyzed in the neonates with blood-type A or B.The incidence and the pathogenic time of hyperbilirubinemia in newborns were studied by gravidity and test results.Results (1) There was no significant difference in the antigenic titer of anti-A(B) IgG,test results of umbilical blood and the incidence of hyperbilirubinemia between the first and the second pregnancy (P>0.05).(2) With the antigenic titer of anti-A(B) IgG increased,there was significant difference in the positive rate of antibody releasing test to newborns,positive rate of free antibody and the incidence of hyperbilirubinemia (P<0.01).(3) The incidence of hyperbilirubinemia in neonates whose results of antibody releasing test were positive and the antigenic titer of anti-A(B) IgG≤1∶64 were much higher than control group(P<0.01).(4)There was no significant difference in the incidence of hyperbilirubinemia in 3 days after birth (P>0.05).Conclusion The gravidity is not correlative with the antigenic titer of anti-A(B) IgG and the incidence of hyperbilirubinemia in neonates.The risk of hyperbilirubinemia in neonates increases as the antigenic titer of anti-A(B) IgG in gravida ≥1∶32.The incidence of hyperbilirubinemia in neonates become higher as the antigenic titer of anti-A(B) IgG in their mother increasing,however,it has no influence on the onset time of hyperbilirubinemia in newborns.