不同产次O型血孕妇分娩前IgG抗体效价与新生儿溶血病发生的相关性分析

代淑华; 田玲; 王菀菀; 王欲; 唐伟纯; 吴冬会

不同产次O型血孕妇分娩前IgG抗体效价与新生儿溶血病发生的相关性分析

Analysis of the relationship between the igg antibody titer of O-type blood pregnant women in different parities and the incidence of neonatal hemolytic disease

摘要

摘要:
目的： 探究不同产次O型血孕妇分娩前检测IgG抗A(B)抗体效价与分娩后新生儿溶血病(HDN)发生率的关系。
方法： 选取血型鉴定为“O”型产妇745例，检测其分娩前IgG抗A(B)抗体效价，分析IgG抗A(B)抗体效价分布情况及其与HDN发病率的关系。
结果： 随着孕妇IgG抗A(B)抗体效价升高，HDN发病率逐渐增高。IgG抗A(B)抗体效价≤1∶32、1∶64、1∶128、1∶256、IgG抗A(B)抗体效价≥512 HDN发病率分别为3.97%、6.52%、25.49%、56.76%、98.11%，组间比较差异有统计学意义（P ＜ 0. 01）。非初产妇HDN发病率高于初产妇（P ＜ 0. 01）。妻-夫血型O-A组、O-B组和O-AB组HDN阳性率分别为19.31%、19.40%和19.25%，不同血型丈夫的孕妇HDN阳性率差异无统计学意义（P ＞ 0.05）。以1∶64作为临界值，孕妇IgG-抗A(B)抗体效价诊断HDN与金标准检测方法一致性可信度高（Kappa值 = 0.933，P ＜ 0. 01）。
结论： 非初产妇HDN发病率高于初产妇。HDN发生不受丈夫血型影响。HDN发生率与分娩前孕妇IgG抗A(B)抗体效价有关，随IgG抗A(B)抗体效价升高，HDN发病率越高。孕妇IgG-抗A(B)抗体效价≥1∶64时，其新生儿罹患HDN风险高，应重视。

Abstract:
Objective To explore the relationship between the detection of IgG anti-A(B) antibody titer before delivery and the incidence of neonatal hemolytic disease (HDN) in pregnant women with different blood type O parturients.
Methods 745 parturients with blood type "O" were selected to detect the titer of IgG anti-A(B) antibody before delivery, and analyze the distribution of IgG anti-A(B) antibody and its relationship with the incidence of HDN.
Results The incidence of HDN increased with the increase of IgG anti-A(B) antibody titer. The incidence rates of IgG anti-A(B) antibody titer ≤1∶32, 1∶64, 1∶128, 1∶256 and IgG anti-A(B) antibody titer ≥512 of HDN were 3.97%, 6.52%, 25.49%, 56.76% and 98.11%, respectively. The incidence of HDN in non-primipara was higher than that in primipara, and the difference between the two groups was statistically significant (P ＜ 0.01). The HDN positive rates of the O-A, O-B and O-AB groups were 19.31%, 19.40% and 19.25%, respectively. There was no significant difference in the HDN positive rates of pregnant women with different blood type husbands (P ＞ 0.05). Taking 1∶64 as the critical value, the titer of IGg-anti-A(B) antibody in pregnant women in the diagnosis of HDN was highly consistent with the gold standard detection method (Kappa value = 0.933, P ＜ 0.01).
Conclusions The incidence of HDN in non-primipara was higher than that in primipara. The occurrence of HDN is not affected by the husband's blood type. The incidence of HDN is related to the titer of IgG anti-A(B) antibody in pregnant women before delivery, and the incidence of HDN increases with the increase of IgG anti-A(B) antibody titer. When the titer of IGg-anti-A(B) antibody in pregnant women is ≥1∶64, the risk of HDN in newborns is high,which should be closely monitored.

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