{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T01:47:33Z","timestamp":1780105653537,"version":"3.54.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T00:00:00Z","timestamp":1722816000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the risk of low-level blood group antibody-mediated hemolysis in ABO-incompatible newborns with negative three hemolysis tests, aiming to assist in the identification and management of neonatal jaundice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective case-control study was performed in 892 children with jaundice. The patients were divided into three groups: group I, ABO compatible, negative three hemolysis tests; group II, ABO incompatible, negative three hemolysis tests; and group III, ABO incompatible, positive three hemolysis tests. We analyzed the differences in clinical data, blood routine and biochemical laboratory results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>(1) Patients in group II had higher levels of mean corpuscular volume (MCV), standard deviation of red blood cell volume distribution width (RDW-SD), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and bile acid (BA) than those in group I (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.05). However, there were no statistically significant differences in the MCV, ALT, ALP and BA levels between groups II and III (<jats:italic>P<\/jats:italic>\u2009&amp;gt;\u20090.05). (2) Mean corpuscular hemoglobin concentration (MCHC) &amp;gt;359.5\u2005g\/L, cell volume distribution width (RDW-CV) &amp;gt;15.95%, and reticulocyte count (RET) &amp;gt;4.235% were identified as independent predictors of positive hemolysis test results (<jats:italic>P<\/jats:italic>\u2009&amp;lt;\u20090.001). The combination of MCHC, RDW-CV, and RET% yielded an AUC of 0.841.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Low-level blood group antibody-mediated hemolysis may occur in ABO-incompatible neonates even when three hemolysis tests are negative. Changes in liver function parameters must be monitored. The combination of MCHC, RDW-CV, and RET% can be used to improve the detection rate of HDN.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1392308","type":"journal-article","created":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T04:58:04Z","timestamp":1722833884000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Risk of low levels of blood group antibodies mediating hemolysis in ABO-incompatible neonates with negative three hemolysis tests"],"prefix":"10.3389","volume":"12","author":[{"given":"Hongxing","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingxiang","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaosong","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengwen","family":"Que","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhui","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,8,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1007\/s00431-022-04724-0","article-title":"History and current standard of postnatal management in hemolytic disease of the fetus and newborn","volume":"182","author":"De Winter","year":"2023","journal-title":"Eur J Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1182\/asheducation-2015.1.146","article-title":"Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn","volume":"2015","author":"Delaney","year":"2015","journal-title":"Hematol Am Soc Hematol Educ Program"},{"key":"B3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1017\/9781108773584.011","article-title":"Hemolytic disease of the fetus and newborn maternal antibody mediated hemolysis","volume-title":"Neonatal Hematology. 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