Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Routine blood typing and DAT in infants of group O mothers

Journal of Perinatology volume 33, page 579 (2013)Cite this article

Subjects

We were pleased to see the study by Drs Shahid and Graba1 documenting (again) the low yield from the routine performance of blood typing and direct antibody testing (DAT) on infants of mothers with blood type O.2, 3 It is important to note, however, that the Loyola investigators performed a predischarge total serum bilirubin (TSB) measurement at age 24 h on all infants. They don’t provide additional details regarding the risk assessment they performed, but one assumes that they utilized the predischarge TSB as a key component of this assessment.

We stopped doing a blood type and DAT on infants of group O mothers some 20 years ago but we have measured the transcutaneous bilirubin (TcB) daily on all newborns since 1990. There are now several studies confirming that the predischarge, hour specific, bilirubin measurement, together with the infant’s gestational age, provides the information we need to allow an accurate and clinically relevant prediction of the risk, or lack of risk, of subsequent hyperbilirubinemia.4, 5, 6, 7

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Shahid R, Graba S . Outcome and cost analysis of implementing selective Coombs testing in the newborn nursery. J Perinatol 2012; 32: 966–969.

    Article  CAS  Google Scholar 

  2. Madlon-Kay DJ . Identifying ABO incompatibility in newborns: selective vs automatic testing. J Fam Prac 1992; 35: 278–280.

    CAS  Google Scholar 

  3. Leistikow EA, Collin MF, Savastano GD et al. Wasted health care dollars Routine cord blood type and Coombs’ testing. Arch Pediatr Adolesc Med 1995; 149: 1147–1151.

    Article  CAS  Google Scholar 

  4. Bhutani VK, Stark AR, Lazzeroni LC, Poland R, Gourley GR, Kazmierczak S et al. Predischarge screening for severe neonatal hyperbilirubinemia identifies infants who need phototherapy. J Pediatr 2012; S0022-3476: 00939–0.

    Google Scholar 

  5. Keren R, Luan X, Friedman S, Saddlemire S, Cnaan A, Bhutani V . A comparison of alternative risk-assessment strategies for predicting significant neonatal hyperbilirubinemia in term and near-term infants. Pediatrics 2008; 121: e170–e179.

    Article  Google Scholar 

  6. Maisels MJ, DeRidder JM, Kring EA, Balasubramaniam M . Routine transcutaneous bilirubin measurements combined with clinical risk factors improve the prediction of subsequent hyperbilirubinemia. J Perinatol 2009; 29: 612–617.

    Article  CAS  Google Scholar 

  7. Kaur S, Chawla D, Pathak U, Jain S . Predischarge non-invasive risk assessment for prediction of significant hyperbilirubinemia in term and late preterm neonates. J Perinatol 2012; 32: 716–721.

    Article  CAS  Google Scholar 

  8. Bhutani VK, Johnson L, Sivieri EM . Predictive ability of a predischarge hour-specific serum bilirubin for subsequent significant hyperbilirubinemia in healthy-term and near-term newborns. Pediatrics 1999; 103: 6–14.

    Article  CAS  Google Scholar 

  9. Kaplan M, Hammerman C, Vreman HJ, Wong RJ, Stevenson DK . Hemolysis and hyperbilirubinemia in direct ABO blood group heterospecific neonates. J Pediatr 2010; 157: 772–777.

    Article  CAS  Google Scholar 

  10. Sgro M, Campbell DM, Kandasamy S, Shah V . Incidence of chronic bilirubin encephalopathy in Canada, 2007-2008. Pediatrics 2012; 130: e886–e890.

    Article  Google Scholar 

  11. Bhutani VK, Johnson LH, Maisels MJ, Newman TB, Phibbs C, Stark AR et al. Kernicterus: epidemiological strategies for its prevention through systems-based approaches. J Perinatol 2004; 24: 650–662.

    Article  Google Scholar 

  12. Maisels MJ, Kring E . Risk of sepsis in newborns with severe hyperbilirubinemia. Pediatrics 1992; 90: 741–743.

    CAS  PubMed  Google Scholar 

  13. Meberg A, Johansen KB . Screening for neonatal hyperbilirubinaemia and ABO alloimmunization at the time of testing for phenylketonuria and congenital hypothyreosis. Acta Paediatr 1998; 87: 1269–1274.

    Article  CAS  Google Scholar 

  14. Maisels MJ, Kring EA . Length of stay, jaundice and hospital readmission. Pediatrics 1998; 101: 995–998.

    Article  CAS  Google Scholar 

  15. American Academy of Pediatrics, Subcommittee on Hyperbilirubinemia. Clinical practice guideline: Management of hyperbilirubinemia in the newborn infant 35 or more weeks of gestation. Pediatrics 2004; 114: 297–316.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Newborn Medicine, Department of Pediatrics, Oakland University William Beaumont School of Medicine, Beaumont Children’s Hospital, Royal Oak, MI, USA

    M J Maisels

  2. Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    J F Watchko

Authors
  1. M J Maisels
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J F Watchko
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M J Maisels.

Ethics declarations

Competing interests

M Jeffrey Maisels is a consultant to Draeger Medical, which markets the Konica Minolta Draeger Air Shields JM-103 transcutaneous bilirubinometer.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Maisels, M., Watchko, J. Routine blood typing and DAT in infants of group O mothers. J Perinatol 33, 579 (2013). https://doi.org/10.1038/jp.2013.6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/jp.2013.6

This article is cited by

Search

Advanced search

Quick links