Hemolytic Events in Rh Positive Neonates Born to Rh Negative Mothers

Background One of the most important cause of severe neonatal hyperbilirubinemia is hemolysis including Rh incompatibility.  The aim of this study was to assess the rate of hyperbilirubinemia due to hemolysis in Rh positive neonates  born to Rh negative mothers. Methods In this retrospective study from March 1998 to February 2003, 60 icteric Rh positive newborns that were born to Rh negative mothers, were studied. The data of  patients were gathered from questionnaires sheets. Results The rate of hemolysis due to Rh incompatibility was 18.3%. The mean age of mothers was 31.9 years (SD:4.6). The mean level of hemoglobin in these patients was significantly lower (P=0.009) and serum bilirubin levels higher than nonhemolytic icteric neonates (P=0.007).  The mean age of onset of jaundice in hemolytic neonates was 1.55 days (SD: 618) and in nonhemolytic patients 2.08 (SD:1.03) days. Exchange blood transfusion was performed for 23 neonates (38.3%). In 61.7% of cases no history of anti-D immunoglobulin given during pregnancy or at delivery was present. Conclusion Due to poor prenatal care consisting of inadequate provision of anti-D immunoglobulin in Rh negative mothers, sensitization to Rh antigen in our Rh negative mothers was considerably high.