国内10省市孕妇孕期IgG血型抗体效价与ABO新生儿溶血病的相关性分析

Relationship between blood group antibody IgG titer of pregnant women and ABO hemolytic disease of newborn in ten provinces and cities in China

目的分析国内10省市孕妇孕期IgG血型抗体效价与ABO新生儿溶血病(Hemolytic disease of newborn,HDN)的相关性。方法对本市300名孕妇及其丈夫进行ABO血型定型;对孕妇血清进行IgG抗-A和(或)抗-B效价测定;孕妇分娩后,对有HDN临床指征的患儿进行ABO血型定型及HDN 3项试验;分析本市及国内其他9省市孕妇IgG血型抗体效价与HDN的相关性。结果本市300名孕妇的ABO血型均为O型,其丈夫为非O型(A、B或AB型)。国内10省市HDN的发生率均随孕妇IgG血型抗体效价的升高而升高;各效价组HDN的发生率10省市间相比,差异均有统计学意义(P均<0.05);合计国内10省市数据,孕妇IgG血型抗体不同效价组间HDN的发生率均有统计学意义(P<0.05),孕妇IgG血型抗体效价与HDN的发生率呈正相关(r=0.866,P<0.05),以抗体效价32～64的HDN发生率增幅最大(440%)。结论孕妇IgG血型抗体效价可作为评估HDN发生风险的指标之一,但并非唯一性指标,还应结合其他检测结果及孕妇临床状况综合分析,做出判断。

Objective To analyze the relationship between blood group antibody IgG titer of pregnant women and ABO he- molytic disease of newborn （HDN）. Methods Three hundreds of pregnant women in Foshan City as well as their husbands were subjected to ABO blood grouping, while the pregnant women were determined for anti-A and/or anti-B IgG titers in sera. From the new- horns with clinical indications of HDN, the blood samples were collected for ABO blood grouping as well as Coomb test, free antibody test and antibody release test. The relationship between blood group antibody IgG titer of pregnant women and HDN in ten provinces and cities including Foshan City in China was analyzed. Results All the 300 pregnant women in Foshan City were of blood group O, while their the husbands were of blood groups A, B or AB. In all the ten provinces and cities, the incidence rates of HDN increased with the increasing blood antibody IgG titers of pregnant women. However, the incidence rate showed significant difference in the newborn deliv- ered by pregnant women with the same IgG titers in various provinces and cities（each P 〈 0. 05） and in the newborns delivered by preg- nant women with various IgG titers （each P 〈 0. 05）. The blood group antibody IgG titers of pregnant women was positively related to the incidence rate of HDN （r = 0. 866, P 〈 0.05）. The increasing fold of incidence rate of HDN in newborns delivered by pregnant women with IgG titers of 32 - 64 was 440%, which was higher than those by pregnant women with other IgG titers. Conclusion The blood group IgG titer of pregnant woman might be used as one of the indexes, but not the only index, for evaluation of risk of HDN. The risk should be evaluated by the IgG titer combined with other test results and clinical status of pregnant women.