The Pattern of ABO Incompatibility in Neonates in Tikur Anbessa Specialized Hospital (TASH), Addis Ababa

Abstract

Background: ABO incompatibility disease is a major morbidity and health problem of neonates
that did not get due attention. To our knowledge, literature informing about ABO
incompatibility disease in the country is scanty, despite considerable numbers of neonates
admitted to newborn units of the few health institutions found in the nation.

Objective: To describe the pattern of ABO incompatibility and modes of therapy and assess
outcome of management of these neonates in Pediatrics and Child Health Department, Faculty
of Medicine, Addis Ababa University, Newborn Unit.

Methods: A retrospective study of 155 newborns with ABO incompatibility admitted to Tikur
Anbessa Specialized Hospital Newborn Unit from January 1, 2002 to Dec 31, 2003 was
conducted. Data were collected from the charts using prepared questionnaire and then
analyzed.

Results: Neonates with blood group A and B were found to be 51.6% and 48.4% respectively.
The number of neonates with the first birthorder was 82(52.9%) and as the birthorder
increases, a decrement in frequency was noted. Newborns who were initially presented with
jaundice on admission were 119 (76.8%). Hyperbilirubinemia was seen in 90 (85.0%) of
neonates and 73 (47%) patients had anemia of varying severity. ABO incompatibility and
hemolytic disease of the newborn was found in 105 (67.7%) and 16 (10.3%) of the neonates
respectively. Phototherapy was rendered to 80 (51.9%) and double volume blood exchange
transfusion was done on 34 (22.1%) of the patients. With these measures, majority of them 147
(94.8%) got improvement and discharged. Two patients developed kernicterus and six neonates
died.

Conclusion: Neonates with blood group A and B who were born to blood group O mothers
developed ABO incompatibility and hemolytic disease of the newborn. These newborns can be
managed at large with phototherapy and in some with double volume exchange transfusion.