Association of ABO and Rh incompatibility with neonatal hyperbilirubinaemia


  • Apexa S. Patel Department of Obstetrics and Gynecology, Sumandeep Vidyapeeth, Piparia, Vadodara, Gujarat, India
  • Deepak A. Desai Department of Obstetrics and Gynecology, Sumandeep Vidyapeeth, Piparia, Vadodara, Gujarat, India
  • Aneri R. Patel Department of Obstetrics and Gynecology, Sumandeep Vidyapeeth, Piparia, Vadodara, Gujarat, India



ABO incompatibility, Rh incompatibility Kernicterus


Background: 60% of term new-born have clinical jaundice, in the first week of life. ABO incompatibility is the most common cause of haemolytic disease of the new-born. So early intervention, at proper time, is mandatory to prevent these sequelae.

Methods: This study was done at Dhiraj Hospital in Obstetrics and Gynecology Department. It was prospective observational study. 200 new-born with ABO incompatibility and 20 new-born with Rh incompatibility, causing clinically significant neonatal hyperbilirubinemia, were recruited for the clinical study noted.

Results: The incidence of ABO incompatibility in our study was 13.79% and of Rh incompatibility was 1.37%. In ABO incompatibility group, 90% new born developed clinical jaundice. In treated group, out of 88 new born, 82 were from O-A and O-B incompatibility group. In ABO incompatibility DCT was positive in only 9%, whereas in Rh incompatibility it was 25%. In ABO incompatibility group, majority, 56% did not require treatment, whereas in Rh incompatibility group 65% required treatment. In ABO incompatibility group only 1% required exchange transfusion whereas in Rh incompatibility, it was required in 10%. In ABO incompatibility, all new-born treated well except, 0.5% developed kernicterus. In Rh incompatibility group, 10% new-born developed kernicterus

Conclusions: In ABO incompatibility, if jaundice develops, it remains in physiological limits. In presence of some aggravating conditions may present as pathological jaundice. It results in significant morbidity but no mortality. So prevention of aggravating factors is very important, in case of ABO incompatibility. 


Global Health Observatory (GHO) data. Neonatal mortality. Available at:

Pathologic hyperbilirubinemia. Available at:

Thor WR Hansen. Chief Editor: Ted Rosenkrantz, MD; Neonatal Jaundice, 2016. Available at

Buchan PC. Pathogenesis of neonatal hyperbilirubinaemia after induction of labour with oxytocin. Br Med J. 1979;2(6200):1255-7.

Huang MJ, Kua KE, Teng HC, Tang KS, Weng HW, Huang CS. Risk factors for severe hyperbilirubinemia in neonates. Pediatr Res. 2004;56(5):682-9.

Christensen RD, Yaish HM. Hemolytic disorders causing severe neonatal hyperbilirubinemia. Clin Perinatol. 2015;42(3):515-27.

Woodgate P, Jardine LA. Neonatal jaundice: phototherapy. BMJ Clin Evid. 2015.

Harrison, KL. Fetal Erythrocyte Lifespan. J Paedia Child Health. 1979;15(2):96-7.

Available at http// /pubs/features/presentations/panda/3/ABO-Rh.ppt. Assessed on 20 November 2009.

Garratty G, Glynn SA, McEntire R. ABO and Rh(D) phenotype frequencies of different racial/ethnic groups in the United States. Transfusion. 2004;44:703-6.

Murray NA, Roberts IAG. Haemolytic disease of the newborn: Arch Dis Child Fetal Neonatal Ed. 2007; 92(2):F83-F88.

Julia A. Oski's Solution: Oski's Pediatrics: Principles and Practice, Plus Integrated Content Website. 4th ed. 443.

Gamaleldin R, Iskander I, Seoud I, Aboraya H, drAravkin A, Sampson PD et al. Risk factors for neurotoxicity in newborns with severe neonatal hyperbilirubinemia. Pediatrics. 2011;128(4).






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