The clinical value of serum bilirubin, hemoglobin, and reticulocyte combined with immunohematological tests in the diagnosis of ABO neonatal hemolytic disease

This study aims to investigate the clinical application value of serum total bilirubin, hemoglobin (Hb) and reticulocyte percentage (Ret%) combined with immunohematological tests in the diagnosis of ABO hemolytic disease of the newborn (ABO-HDN). A retrospective analysis of 503 neonatal blood samples of mothers with RhD(+) blood type O and neonates with RhD(+) blood type A/B, admitted to the Third Xiangya Hospital of Central South University from March 2020 to September 2021, was conducted. HDN was investigated with the elution test, indirect antiglubin test (IAT), and direct antiglubin test (DAT). The positive rate of the immunohematological tests for neonatal hemolysis, combined with the detection of serum total bilirubin, Hb and Ret%, was significantly higher than that of immunohematological tests for neonatal hemolysis alone (P<0.05). The elution test can be used as a gold standard to diagnose HDN. Neonates with blood type A had a higher probability of ABO hemolysis than those with blood type B. This study suggests that serum bilirubin, Hb, and Ret% detection combined with immunohematological tests can improve the detection rate of ABO-HDN.