孕妇IgG抗体效价与新生儿溶血病发病率的相关性

Research on Relationship between IgG Antibody Titer of Pregnant Women and Incidence of Hemolytic Disease of Newborn

目的:探讨孕妇ABO血型免疫球蛋白G(IgG)抗体效价与新生儿溶血病(HDN)发病率的相关性。方法:对1 786例O型孕妇(丈夫非O型)血清IgG抗体效价进行测定,研究其年龄、孕次等因素对抗体效价的影响,研究娩出胎儿HDN的发病情况。结果:不同妻-夫血型组合的抗体效价高低差异无统计学意义(P>0.05);与初次妊娠的孕妇比较,随妊娠次数增多IgG抗体效价显著增高(P<0.05);高龄组孕妇与正常年龄组孕妇比较,随着年龄增加IgG抗体效价显著增高(P<0.05);1 786例"O"型孕妇中,156例娩出的新生儿被确诊为ABO-HDN,孕期IgG抗体效价与ABO-HDN发病率成正相关(r=0.705 3,P<0.05)。结论:孕期动态监测母体IgG抗体效价对HDN发病具有重要提示意义,但不可单纯以抗体效价高低作为判断HDN发病率及胎儿预后的唯一依据。

Objective： To discuss the relationship between IgG antibody titer of pregnant women and incidence of hemolytic disease of newborn （HDN） and provide guidance for early intervention and treatment. Methods： A total of 1 786 pregnant women with type O （their husbands not type O） were enrolled in this study. Their serum IgG antibody titer were determined, the effect of their age and times of pregnancy on IgG antibody titer was analyzed and the relationship between serum IgG antibody titer and the incidence of HDN was analyzed. Results： Wife-husband blood type combination was not sig- nificantly related to the level of IgG antibody titer （P 〉 0.05 ）. With the increase of number of preg- nancies, IgG antibody titers level increased significantly （ P 〈 0.05 ）. With the increase of pregnant woman＇age, IgG antibody titers level increased significantly（P 〈0.05 ）. Among 1 786 cases of blood type O pregnant women, 156 cases were diagnosed as HDN, whose IgG antibody titer levels in pregnancy were positively correlated with incidence of ABO-HDN （ r = 0. 705 3, P 〈 0.05 ）. Conclusion ： Dynamic monitoring IgG antibody titer in pregnancy is significantly important in diagnosing HDN inci- dence, which is beneficial to early intervention and treatment of the disease. However, the level of IgG antibody titers is not a sole basis for judging HDN incidence and fetal prognosis.