Maternal IgG Anti-A and Anti-B Titer Levels Screening in Predicting ABO Hemolytic Disease of the Newborn: A Meta-Analysis

Fetal Pediatr Pathol. 2015;34(6):341-50. doi: 10.3109/15513815.2015.1075632. Epub 2015 Sep 11.

Abstract

Maternal IgG anti-A/B titers have been considered as a susceptible factor to the risk of ABO hemolytic disease in newborn (ABO-HDN). However, the results remain controversial. This meta-analysis aimed to estimate the association between maternal IgG anti-A/B titers and the risk of ABO-HDN.

Methods: Trials on the relationship between maternal IgG anti-A/B titers and the risk of ABO-HDN were collected by searching Embase, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL) electronic databases. The inclusion criteria were maternal IgG anti-A/B titers screening and the evaluation of clinical outcomes in relation to ABO-HDN. Stata 12.0 was used to analyze the data.

Results: A total of 23 trials were eligible for inclusion, of which four trials with 5,246 participants were suitable for this meta-analysis. Meta-analysis results suggested that maternal IgG anti-A/B titers were significantly associated with the risk of ABO-HDN [OR = 2.86, 95% CI = 2.50-3.28; OR = 4.67, 95% CI = 3.92-5.55; OR = 1.61, 95% CI = 1.36-1.91 in titers (128 to 256) vs. titers (64 or lower), titers (512 or higher) vs. titers (64 or lower), and titers (512 or higher) vs. titers (128-256), respectively].

Conclusions: Our meta-analysis suggests that maternal IgG anti-A/B titers are significantly associated with the risk of ABO-HDN. They contribute to the prediction of risk of ABO-HDN, in addition to the need for invasive treatment for antibody titers ≥512.

Keywords: ABO antibody titer; ABO hemolytic disease of the newborn; ABO incompatibility.

Publication types

  • Meta-Analysis

MeSH terms

  • ABO Blood-Group System / blood
  • ABO Blood-Group System / immunology*
  • Erythroblastosis, Fetal / blood*
  • Erythroblastosis, Fetal / immunology*
  • Female
  • Humans
  • Immunoglobulin G / blood*
  • Infant, Newborn
  • Mothers
  • Risk Factors

Substances

  • ABO Blood-Group System
  • Immunoglobulin G