Relationship between maternal and infant outcomes of “two-child” and Rh hemolysis disease of newborn
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摘要: 目的:探讨“二孩”的母婴结局与新生儿Rh溶血病(Rh-HDN)的关联。方法:随机选取2019年7月—2020年7月检查的512例“二孩”新生儿及其母亲作为研究组,同期530例“一孩”新生儿及其母亲作为对照组,检测2组新生儿及其母亲的Rh血型、不规则抗体及抗体效价,记录Rh-HDN发生情况;比较2组Rh-HDN的发生率,对Rh-HDN患儿的治疗及结局进行分析。结果:研究组发现12例(2.34%)母亲不规则抗体阳性,对照组发现2例(0.38%)母亲不规则抗体阳性,差异有统计学意义(P<0.05);研究组发现Rh-HDN 10例(1.95%);对照组发现Rh-HDN 1例(0.19%),差异有统计学意义(P<0.05);11例Rh-HDN患儿,5例治愈出院;5例预后不佳,好转出院;1例拒绝治疗自行出院。结论:“二孩”比“一孩”出现Rh-HDN的概率大;“二孩”孕妇产前应注重不规则抗体筛查,Rh 5种抗原检测,为临床治疗提供依据。Abstract: Objective: To explore the relationship between maternal and infant outcomes of "two-child" and Rh hemolysis disease of newborn(Rh-HDN).Methods: A total of 512 "two-child" newborns and their mothers examined in our hospital from July 2019 to July 2020 were randomly selected as the research group, and 530 "one-child" newborns and their mothers during the same period were randomly selected as the control group. The Rh blood type, irregular antibodies and antibody titers of the newborns and their mothers in the two groups were detected, and the occurrence of Rh-HDN was recorded. The incidence of Rh-HDN in the two groups was compared, and the treatment and outcome of children with Rh-HDN were analyzed.Results: In the study group, 12 cases(2.34%) of mothers were positive for irregular antibodies, and 2 cases(0.38%) of mothers were positive for irregular antibodies in the control group, the difference was statistically significant(P<0.05). In the study group, 10 cases(1.95%) were Rh-HDN, and 1 case(0.19%) was Rh-HDN in the control group, the difference was statistically significant(P<0.05). Among the 11 children with Rh-HDN, 5 cases were cured and discharged; 5 cases had poor prognosis and were discharged after improvement, and 1 case refused treatment and self-discharged.Conclusion: "Two-child" newborns might be more likely to have Rh-HDN than "one-child" newborns. Prenatal screening of irregular antibodies and Rh 5 antigens should be paid attention to "two-child" pregnant women, so as to provide basis for clinical treatment.
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Key words:
- "two-child" /
- Rh hemolysis disease of newborn /
- irregular antibody /
- Rh blood type
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[1] 祝丽丽,丛硕,赵鲁强,等.二孩孕妇Rh血型抗体与新生儿溶血病的关系[J].贵州医科大学学报,2019,44(12):1458-1461.
[2] Maisonneuve E,Jayot A,Friszer S,et al.Accuracy of Middle Cerebral Artery Doppler Assessment between 34 and 37 Weeks in Fetuses with Red Cell Alloimmunization[J].Fetal Diagn Ther,2017,42(3):225-231.
[3] 林秦燕,项静婉.Rh抗E和抗c致重症新生儿溶血症1例[J].中国乡村医药,2019,26(5):45-45,47.
[4] 周明,王慧茹,陈洋,等.孕产妇Rh血型系统抗体检测和临床意义分析[J].安徽医药,2020,24(2):252-256.
[5] 谢晓绘,张晓菊,周丹,等.Rh(D)阴性经产妇应用抗-D免疫球蛋白预防胎儿及新生儿溶血病疗效观察[J].解放军医学院学报,2019,40(12):1122-1126,1159.
[6] 尚红,王毓三,申子瑜.全国临床检验操作规程[M].4版.北京:人民卫生出版社,2015.
[7] 王卫平.毛萌.李延玉.儿科学[M].8版.北京.人民卫生出版社,2013:122-125.
[8] 尹明伟,陈学军,曾智,等.母婴ABO血型不相合的高胆红素血症患儿新生儿溶血病确诊率的影响因素分析[J].国际检验医学杂志,2020,41(06):663-666+670.
[9] 包碧惠,徐忠兰,陈芹,等.胎婴儿Rh溶血病的临床诊治进展[J].西南军医,2017,19(3):279-281.
[10] Olds C,Oghalai JS.Audiologic impairment associated with bilirubin-induced neurologic damage[J].Semin Fetal Neonatal Med,2015,20(1):42-46.
[11] 林甲进,朱碎永,张瑛.Rh新生儿溶血病的血清抗体分析[J].中国实验诊断学,2007,(12):1634-1635.
[12] 张爱,林洪铿,何觅,等.福州地区献血人群Rh血型分布特征的调查分析[J].福建医药杂志,2020,42(2):125-127.
[13] 杨茹,李刚,何欣,等.Rh、MNS等血型系统不规则抗体导致新生儿溶血病的实验室检测分析[J].临床血液学杂志,2019,32(2):109-112.
[14] 赵倩,王振雷,何路军,等.Rh血型系统意外抗体致新生儿溶血病的实验室分析[J].河北医学,2018,24(2):283-286.
[15] 包碧惠,徐忠兰,陈芹,等.胎婴儿Rh溶血病的临床诊治进展[J].西南军医,2017,19(3):279-281.
[16] 朱加强.40例行换血治疗的Rh血型系统新生儿溶血病分析[J].临床血液学杂志,2020,33(10):704-706.
[17] 李倩倩,董小玥,乔瑜,等.江苏省13家医院新生儿严重高胆红素血症现状调查[J].中国当代儿科杂志,2020,22(7):690-695.
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