Clinical value of combination detection of direct antiglobulin test and serum albumin globulin ratio in severe hyperbilirubinemia caused by ABO hemolytic disease of the newborn

Figures & data

Figure 1. Flowchart of the study population.

Table 1. Baseline characteristics of study population.

Characteristics	With blood components	Without blood components	p	DAT> ±	DAT＜±	p	AGR <2.05	AGR >2.05	P
Male(Female)	52(57)	95(66)							.077
Cesarean Section(Vaginal Delivery)	47(62)	68(93)	.885	31(38)	84(117)	.649	35(47)	80(108)	.984
Primipara(Multipara)	38(71)	67(94)	.264	21(48)	84(117)	.066	29(52)	76(112)	.246
Feeding Mode			.485			.000			.004
Breast Feeding	13	24		3	34		5	32
Artificial Feeding	48	52		39	61		41	59
Mixed Feeding	48	85		27	106		36	97
Neonatal ABO Blood Type			.532			.225			.644
A	55	75		29	101		35	95
B	54	85		40	99		34	105
AB	0	1		0	1		0	1
Age of Mothers(y)	30.1 ± 4.2	30.7 ± 3.5	.317	30.4 ± 3.8	30.6 ± 3.8	.767	30.4 ± 4.1	30.6 ± 3.6	.649
Gestational Day(d)	274.2 ± 6.6	272.9 ± 6.8	.101	275.1 ± 6.5	272.8 ± 6.7	.015	274.4 ± 7.0	273.0 ± 6.6	.115
Birth Weight(g)	3394.1 ± 420.9	3285.7 ± 401.0	.064	3363.6 ± 404.5	3317.7 ± 414.7	.624	3379.9 ± 473.5	3307.5 ± 381.2	.184
Hospitalization Weight(g)	3298.1 ± 408.2	3202.9 ± 426.5	.068	3269.1 ± 390.3	3231.8 ± 431.6	.526	3277.1 ± 439.8	3225.7 ± 412.8	.358
Age of Jaundice(d)	1.0(.0,2.0)	2.0(1.0,3.0)	.000	.0(.,1.0)	2.0(1.0,3.0)	.000	1.0(.0,2.0)	2.0(1.0,3.0)	.000
Age of Peak Total Bilirubin(d)	2.0(1.0,6.0)	3.0(2.0,6.0)	.007	1.0(1.0,2.0)	3.0(2.0,6.0)	.000	2.0(1.0,4.0)	3.0(2.0,6.0)	.000
Age of Hospitalization(d)	2.0(1.0,5.0)	3.0(2.0,5.0)	.000	2.0(1.0,4.0)	3.0(2.0,6.1)	.000	2.0(1.0,3.0)	3.0(2.0,5.8)	.000
Phototherapy Day(d)	6.9 ± 1.9	6.1 ± 1.6	.000	7.28 ± 2.1	6.2 ± 1.6	.000	6.8 ± 1.8	6.3 ± 1.8	.031
Hospitalization Day(d)	7.7 ± 2.3	6.7 ± 1.7	.000	8.2 ± 2.5	6.8 ± 1.7	.000	7.5 ± 1.8	7.0 ± 2.1	.063
Peak Total Bilirubin(μmol/L)	287.6 ± 100.5	236.0 ± 53.2	.000	247.4 ± 88.5	260.1 ± 76.7	.256	249.8 ± 70.0	259.9 ± 83.8	.342
HGB(g/L)^a	151.4 ± 26.6	162.8 ± 21.2	.000	145.9 ± 25.5	162.4 ± 22.2	.000	158.0 ± 30.7	158.2 ± 20.8	.934
RBC(10^12/L)^a	4.19±.8	4.8 ± 2.7	.015	4.0±.7	4.8 ± 2.4	.010	4.4±.9	4.7 ± 2.5	,290
AGR^b	2.15±.97	2.75±.78	.000	2.25 ± 1.03	2.6±.84	.005	–	–	–
DAT			.000			–			.012
Negative	66	135		–	–		52	149
±	4	3		–	–		1	6
1+	22	16		–	–		17	21
2+	16	7		–	–		11	12
3+	1	0		–	–		1	0
With blood components(without)	–	–	–	43(26)	66(135)	.000	59(23)	50(138)	.000

^a From the first blood routine samples collected after admission.

^b From the samples with the peak total bilirubin.

Table 2. Distribution of blood components.

	N
Blood Components
No	161
Yes	109
Types of Infusions
IVIG	78
Albumin	1
Exchange transfusion therapy	1
IVIG + Exchange transfusion therapy	11
IVIG + RBC	8
IVIG + Albumin	8
IVIG + Albumin + Exchange transfusion therapy	1
IVIG + Albumin + RBC	1
Number of Infusions
One	65
Two	29
Three	13
More Than Three	2

Table 3. Predictors for blood components transfusion in infants with ABO-HDN hyperbilirubinemia.

Characteristic	Crude OR	95%CI		p	Adjusted OR	95%CI		p
Peak Total Bilirubin	1.009	1.006	1.103	.000	1.031	1.022	1.040	.000
AGR	.355	.241	.522	.000	.162	.095	.276	.000
Age of Jaundice	.828	.703	.975	.023	.788	.552	1.124	.189
Age of Hospitalization	.912	.842	.989	.026	.786	.557	1.110	.172
HGB	.979	.969	.990	.000	.970	.934	1.007	.114
RBC	.420	.286	.618	.000	.647	.196	2.137	.475
DAT(±)	2.272	.593	12.540	.197^a^b	1.533	.544	4.319	.015^a^b
DAT(1+)	2.812	1.385	5.710	.004^a	2.489	.670	9.240	.004^a
DAT(2+)	4.968	1.964	12.567	.001^a	5.768	.934	35.641	.001^a

^aCompared with DAT negative.

^bAlthough the p value of DAT ± was .197, the p value of DAT was .015 by the univariate binary logistic regression analysis and DAT ± was one classification of DAT intensity levels. Therefore, DAT ± was entered in the multivariate binary logistic regression analysis.

Figure 2. ROC Curves of DAT, AGR and combination detection of DAT and ARG.

Figure 3. (A) The difference of phototherapy day of three groups. (B) The difference of hospitalization day of three groups.