母胎ABO血型不合孕妇血型IgG抗体效价与围产儿溶血病相关性分析

Correlation analysis between blood type IgG antibody valence and hemolytic disease of newborn(HDN) of pregnant women with maternalfetal ABO blood type incompatibility

目的：探讨母胎ABO血型不合孕妇中孕妇血型IgG抗体效价与围产儿溶血病（HDN）相关关系。方法以2011年9月~2014年2月于我院产科分娩的2137例血型不合产妇及其新生儿为研究对象,以产前最后一次血清IgG抗效价≥64为临床标准,生产后,对新生儿进行溶血病（HDN）相关指标检查,分析孕妇血型IgG抗体效价与围产儿溶血病（HDN）之间的相关关系以及危险因素。结果2137例ABO血型不合孕妇中有458例围产儿发生溶血病,随着产妇IgG抗体效价的不断增高,新生儿溶血病的发生率呈显著上升趋势,经过皮尔逊相关分析,相关系数为r=0.82,单因素分析发现,妊娠次数的增多、年龄增大、不良生育史等因素是导致新生儿发生溶血病（HDN）的独立危险因素。结论产前应加强对夫妇及胎儿的血型检查,及时对母胎ABO血型不合孕妇进行IgG抗体检测,尤其对高龄、多次妊娠以及有不良妊娠史的产妇严密监控,适当实施干预,尽力避免新生儿溶血病（HDN）的发生。

Objective To investigate the correlation between the blood type IgG antibody valence and the hemolytic disease of newborn （HDN） of the pregnancy women with maternal-fetal ABO blood type incompatibility. Methods 2137 pregnant women with blood type incompatibility who delivered in the obstetrical department of our hospital from September 2011 to February 2014 and their neonates were selected as the study subjects. The last serum IgG antibody valence equal to or greater than 64 served as the clinical standard. After birth, the neonates＇ HDN related indicators were examined. The correlation between pregnant women＇s blood type IgG antibody valence and HDN and the risk factors were analyzed. Results Of the 2137 pregnant women with ABO blood type incompatibility, 458 perinatal infants had hemolysis. As the pregnant women＇s IgG antibody valence increased, the incidence of HDN rose significantly;Pearson correlation analysis showed that the correlation coefficient was r=0.82. Univariate analysis found that increase of number of pregnancies, increase of age, poor childbearing history and other factors were independent risk factors of HDN. Conclusion Before birth, blood type examination of couples and fetuses should be enhanced, IgG antibody de-tection of pregnant women with maternal-fetal ABO blood type incompatibility should be conducted, the pregnant women with advanced age, multiple pregnancies and adverse pregnancy history should be monitored closely, and proper intervention should be implemented in order to avoid the occurrence of HDN.