Hemolytic Disease of the Newborn Due to Rh Incompatibility in a Neonatal Intensive Care Unit

Objective: The aim of this study was to analyze hemolytic disease of the newborn (HDN) induced by Rh incompatibility in Taiwan and to compare the characteristics and clinical data with that of HDN induced by ABO incompatibility.Methods: From January 2000 to December 2005, fifty-five newborns were hospitalized in our neonatal intensive care unit (NICU) due to severe hyperbilirubinemia. A complete jaundice survey was done, which included reticulocyte count, serum glucose-6-phosphate dehydrogenase (G6PD), and direct and indirect antiglobulin tests. We collected data on the birth history, laboratory studies, and hospitalization course of these patients for further analysis.Results: Thirty-three patients were excluded and a total of 22 patients were enrolled in this study. These patients included 12 with Rh incompatibility (group 1) and 10 with HDN induced by ABO incompatibility (group 2). There were no statistically significant differences (p＞0.05) in gestational age, birth weight, initial hemoglobin level, number of blood exchange transfusions, or days of hospitalization between these two groups. Eight of the 12 Rh incompatibility cases were due to Rh(E+c) incompatibility, 1 was due to Rh(E) incompatibility, and 1 was due to Rh(c) incompatibility. The other 2 had Rh (D) incompatibility.Conclusion: Most cases of HDN-induced by Rh incompatibility in Taiwan are due to anti-Rh (E), anti-Rh (E+c), and anti-Rh(c).