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©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
Rh-incompatible hemolytic disease of the newborn in Hefei
Shao-Hua Bi, Liang-Liang Jiang, Li-Ying Dai, Hong Zheng, Jian Zhang, Li-Li Wang, Chao Wang, Qiao Jiang, Yu Liu, Yong-Li Zhang, Juan Wang, Chao Zhu, Guang-Hui Liu, Ru-Jeng Teng
Shao-Hua Bi, Li-Ying Dai, Hong Zheng, Jian Zhang, Yu Liu, Yong-Li Zhang, Juan Wang, Guang-Hui Liu, Divisions of Neonatology, Anhui Provincial Children’s Hospital, Hefei 230022, Anhui Province, China
Liang-Liang Jiang, Pediatrics Neurology, Anhui Provincial Children’s Hospital, Hefei 230022, Anhui Province, China
Li-Li Wang, Chao Zhu, Division of Neonatology, First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Chao Wang, Hefei Blood Center, Hefei 230022, Anhui Province, China
Qiao Jiang, Clinical pathology, Anhui Provincial Children’s Hospital, Hefei 230022, Anhui Province, China
Ru-Jeng Teng, Division of Neonatology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI 53226, United States
Author contributions: Bi SH and Teng RJ designed the research; Bi SH, Liu GH, and Teng RJ drafted the manuscript; Bi SH, Jiang LL, Dai LY, Zheng H, Zhang J, Liu Y, Zhang YL, and Wang J obtained the informed consents reviewed the medical records; Wang C and Jiang Q performed the laboratory tests; Bi SH, Zhu C, Liu GH, and Teng RJ performed the data analysis; Wang LL, Zhu C, Liu GH, and Teng FJ revised the manuscript; Bi SH, Zhu C, Liu GH, and Teng RJ finalized the manuscript.
Institutional review board statement: See uploaded file for IRB approval in Chinese.
Conflict-of-interest statement: The authors report no relevant conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Data sharing statement: Deidentified raw data can be obtained from the authors upon official request for research purpose only.
Corresponding author: Guang-Hui Liu, MD, Chief Doctor, Division of Neonatology, Anhui Provincial Children’s Hospital, Anhui Medical University, Wangjiang E. Rd, Hefei 230022, Anhui Province, China. lgh508@sina.com
Telephone: +86-551-62237807
Received: July 23, 2019
Peer-review started: July 23, 2019
First decision: September 9, 2019
Revised: September 22, 2019
Accepted: October 5, 2019
Article in press: October 5, 2019
Published online: October 26, 2019
Processing time: 94 Days and 13.6 Hours
ARTICLE HIGHLIGHTS
Research background
Before the discontinuation of the national population policy one-child policy–Rh-hemolytic disease of the newborn (HDN) was a rare cause of severe neonatal jaundice in China. Different from Caucasian population, RhD (-) is extremely rare in Chinese. We experienced a dramatical increase in Rh-HDN since the discontinuation of the national population policy which we believe will impact our management of neonatal jaundice nationwide. The lack of our own epidemiologic data will hinder our generation of public health policy judging from the severe consequence of bilirubin induced neurologic deficit.
Research motivation
To share our experience with our colleagues to encourage a statewide or nationwide collaboration to study Rh-HDN in Chinese.
Research objectives
The investigate the distribution of Rh antibodies in Chinese HDN and the clinical manifestation.
Research methods
Retrospective chart review of prospectively collected cohort over 18 mo in one free standing Children’s Hospital.
Research results
Rh-HDN accounted for 0.43% (18 out of 4138) of all HDN and 72.2% (13/18) were qualified for BET. No mother received antenatal Rhogam injection. The most common antibody involved was anti-E (55%, 10/18). The risk for BET was similar between anti-D (100%) and anti-E (81.8%) Rh-HDN.
Research conclusions
Anti-E antibody is the most common cause of Rh-HDN in Chinese. Our limited experience showed the severity of RhE neonatal jaundice is no less severe than the RhD neonatal jaundice.
Research perspectives
More extensive study in Rh-HDN is warranted after the change of our national population policy. The severity of Rh-HDN to both pregnant women and fetus deserve our attention. Collaboration among perinatology, neonatology, hematology, and immunology is needed to provide the best care for our next generation.
