Potential Causes of HDFN among Neonates Delivered in Specialist Hospital Sokoto, Nigeria

Abstract

Haemolytic disease of the Foetus and New-born (HDFN) is an autoimmune haemolytic disease caused by feto-maternal blood group incompatibility which usually occurs in foetuses and new-borns. The aim of this study was to find out the percentage prevalence of positive DAT among babies' due to IgG antibodies. This descriptive study was carried out among 79 singleton babies born in Specialist Sokoto, North-Western Nigeria to determine invivo sensitization of the foetal red cells to IgG antibodies. Three millilitres of Cord blood were collected, and the red cells were screened for in-vivo sensitization using Ortho Biovue (U.S.A.) Column Agglutination Technology based DAT cassettes. The study showed that four out of seventy-nine singletons, had positive DAT. ABO and Rhesus D blood group was determined on samples from the mothers and the neonates. ABO, Rhesus D and direct antiglobulin (IgG) test was carried out on samples from the mothers and babies using the Column agglutination technique (Ortho Diagnostics, USA). ABO blood group distribution among the mothers indicated that 22(27.8%), 12(15.2%), 1(1.3%) and 44 (55.7%) were blood group A, B, AB and O respectively. ABO blood group distribution among the babies indicated that 21(26.6%), 20(25.3%), 2(2.5%) and 36(45.6%) were ABO group A, B, AB and O respectively. Among the mothers 74(93.7%) were Rh D Positive while 5(6.3%) were Rh D negative. Among the babies, 75(94.9%) were Rh D positive and 4(5.1%) were Rh D negative. Among the 79 babies, the DAT (ABO-IgG) test was positive in 4(5.1%). The positive DAT was due to ABO group incompatibility among 2(2.5%) while Rh D incompatibility (Rh D-IgG) was responsible for the positive DAT in 2(2.5%) of the subjects. In conclusion, we have observed in this study that HDFN due to ABO incompatibility and Rh D incompatibility are common among babies of African descent delivered in Sokoto, Nigeria. There is need to implement best practices in the prevention, diagnosis and optimal management of HDFN in Sokoto in particular and Nigeria in general.