Diagnostic value of three hemolysis tests combined with serum bilirubin detection for hemolytic disease of newborn with hyperbilirubinemia
Hu Cailing
Abstract：Objective To study the diagnostic value of three hemolysis tests(direct anti-human globulin test,serum free antibody test,antibody release test)combined with serum bilirubin detection for hemolytic disease of newborn(HDN)with hyperbilirubinemia.Methods The clinical data of 100 newborns in obstetrics department of Meizhou Maternal and Child Health Hospital from June 2022 to April 2023 were collected and analyzed retrospectively.They were divided into different O-A/B blood type group(55 cases)and same O-O blood type group(45 cases)according to maternal and infant blood types.The level of serum bilirubin,positive rates of three hemolysis tests and incidence of HDN with hyperbilirubinemia were compared between two groups.According to the results of three hemolysis tests,the children were divided into group A[1 case;direct antibdy test(+),free antibdy test(+),antibdy release test(+)],group B[10 cases;direct antibdy test(+),free antibdy test(-),antibdy release test(+)],group C[13 cases;direct antibdy test(-),free antibdy test(+),antibdy release test(+)],group D[8 cases;direct antibdy test(-),free antibdy test(-),antibdy release test(+)]and group E[68 cases;direct antibdy test(-),free antibdy test(-),antibdy release test(-)].The serum bilirubin levels were compared among all groups.According to serum bilirubin level,the newborns were divided into 0-21 μmol/L group(4 cases),>21-35 μmol/L group(49 cases),>35-45 μmol/L group(33 cases),>45-55 μmol/L group(10 cases)and>55 μmol/L group(4 cases),and the incidence of HDN with hyperbilirubinemia was compared.The diagnostic value of three hemolysis tests combined with serum bilirubin detection for HDN with hyperbilirubinemia was analyzed using diagnostic tests.Results The incidence of HDN with hyperbilirubinemia was 32.00%(32/100).The serum bilirubin level in different O-A/B blood type group was higher than that in same O-O blood type group(μmol/L:37.80±10.25 vs.33.79±8.16,P<0.05).The positive rates of free antibody test and antibody release test and the incidence of HDN with hyperbilirubinemia in different O-A/B blood type group were higher than those in same O-O blood type group(positive rate of free antibody test:25.45%vs.2.22%;positive rate of antibody release test:32.73%vs.2.22%;incidence of HDN with hyperbilirubinemia:45.45%vs.15.56%;all P<0.05).The serum bilirubin levels in groups A,B,C and D were higher than that in group E(39.3,47.46±12.05,45.31±10.28,34.62±7.82 vs.22.57±4.38,all P<0.05).There was no statistically significant difference in serum bilirubin levels between group B and group C,but both were significantly higher than that of group D(both P<0.05).The incidence of HDN with hyperbilirubinemia in serum bilirubin>55 μmol/L group was higher than those in 0-21 μmol/L group,>21-35 μmol/L group,>35-45 μmol/L group and>45-55 μmol/L group(100.0%vs.25.00%,24.49%,33.33%,40.00%,all P<0.05).There were no significant differences in the incidence of HDN with hyperbilirubinemia among other groups.When the serum bilirubin was>55 μmol/L,the diagnostic specificity and positive predictive value were both 100.00%and the sensitivity was 86.96%.Conclusion The combined application of three hemolysis tests and serum bilirubin detection has high diagnostic value for HDN with hyperbilirubinemia,which is worthy of clinical promotion.
Keywords：HyperbilirubinemiaHemolytic disease of newbornDirect anti-human globulin testSerum free antibody testAntibody release testSerum bilirubin
Publication Date：2025-03-30
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 52-55 )