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.

  • Correspondence
  • Published:

Absence of severe neonatal ABO hemolytic disease at Intermountain Healthcare. Why?

Journal of Perinatology volume 40, pages 352–353 (2020)Cite this article

Subjects

In the May 2018 issue, we reported the absence of severe neonatal ABO hemolytic disease at Intermountain Healthcare during the period 2004–2016 [1]. In that report we defined severe hemolytic disease as any of the following: (1) a total serum bilirubin (TSB) >25 mg/dL, or (2) rehospitalization for intensive phototherapy, or (3) development of acute bilirubin encephalopathy. In that study of over 400,000 births, we found that neonates born to group O(+) mothers were not more likely to develop severe hemolytic disease when they were blood group A or B (and thus were at some risk for ABO hemolytic disease) than when they were blood group O (and thus were at no risk of ABO hemolytic disease).

The explanation we gave for the absence of severe neonatal ABO hemolytic disease in our health system was unsatisfying to us, and at that time was untestable by us. We do not determine the blood type and DAT of all neonates born to group O women [1], thus screening in that way is not the explanation for our lack of severe cases of ABO hemolytic disease. Rather, we speculated that it was due to our universal neonatal bilirubin management program, where since 2004 every baby born at our hospitals has one or more TSB determinations reported to the clinician, printed on a time-specific (Bhutani) nomogram along with instructions for management and follow-up [2]. We speculated that this system identified neonates with ABO hemolytic disease who developed in-hospital hyperbilirubinemia, and that these were appropriately treated with phototherapy, which prevented evolution to severe hemolytic disease.

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. Christensen RD, Baer VL, MacQueen BC, O’Brien EA, Ilstrup SJ. ABO hemolytic disease of the fetus and newborn: thirteen years of data after implementing a universal bilirubin screening and management program. J Perinatol. 2018;38:517–25.

    Article  CAS  Google Scholar 

  2. Eggert LD, Wiedmeier SE, Wilson J, Christensen RD. The effect of instituting a prehospital-discharge newborn bilirubin screening program in an 18-hospital health system. Pediatrics. 2006;117:e855–62.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Women and Newborn’s Clinical Program, Intermountain Healthcare, Salt Lake City, UT, USA

    Vickie L. Baer & Robert D. Christensen

  2. Division of Neonatology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA

    Whitley Hulse, Timothy M. Bahr & Robert D. Christensen

  3. Transfusion Services and Clinical Pathology, Intermountain Healthcare, Murray, UT, USA

    Sarah J. Ilstrup

  4. Division of Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT, USA

    Robert D. Christensen

Authors
  1. Vickie L. Baer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Whitley Hulse
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Timothy M. Bahr
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sarah J. Ilstrup
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Robert D. Christensen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Whitley Hulse.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Baer, V.L., Hulse, W., Bahr, T.M. et al. Absence of severe neonatal ABO hemolytic disease at Intermountain Healthcare. Why?. J Perinatol 40, 352–353 (2020). https://doi.org/10.1038/s41372-019-0553-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-019-0553-0

This article is cited by

Search

Advanced search

Quick links