Abstract
The study was designed to determine factors responsible for the severe neonatal hyperbilirubinaemia sometimes found in ABO incompatibility in Nigeria. In 50 jaundiced babies who were ABO-incompatible it was found that the mean serum bilirubin level was significantly higher in outpatients than inpatients; this difference was probably due to the delay in recognizing jaundice among the outpatients and, possibly also to the slightly higher number of G-6-PD deficient babies in the same group, and their greater exposure to icterogenic agents. The results of serological studies suggest that ABO-incompatibility was responsible for neonatal jaundice in only 36% of these babies. Among the inpatients the need for exchange blood transfusion was more common in babies of mothers with immune anti-A or anti-B titres of 1:64 or more (P < 0.001). Neonates at risk of ABO-haemolytic disease can be identified at birth by direct positive Coombs test and detection of immune anti-A or anti-B antibodies in the mother's serum.
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