Selection of Blood (Packed RBCs) for Transfusion in Newborn Baby up to the Age of 4 Months

Abstract

Proper selection of donor’s blood group is essential to prevent transfusion hazards. It is known that ABO antigen is fully developed at birth but the newborn baby does not produce ABO antibodies until 3 to 6 months of age. The ABO antibodies present in the serum of newborn babies are derived from mother’s blood due to placental transfer. So the blood group of the newborn baby is done by ABO antigen grouping (forward grouping) only, antibody grouping (reverse grouping) is not required. In case of transfusion of blood in newborn under 4 months of age, cross-matching of donor’s blood is done with the mother’s blood if it is available. We know, recipient’s same group of blood is always preferable in case of transfusion in adults or older children. But selection of blood for transfusion in the infants under 4 months of age depends on the mother’s blood group as well. If the mother’s blood group differs from the infant’s blood group, the infant’s same group of blood may not be selected for transfusion. For example, if the mother’s blood group is “O” and the newborn blood group is “A” or “B”, infant’s same group “A” or “B” group blood could not be transfused, because the anti-A & anti-B antibodies can be derived in the infant’s serum from mother’s blood which may react with the “A” or “B” antigen of the donor’s blood. In this case “O” group packed RBCs should be selected for transfusion. “O” group whole blood may contain IgG anti-A and anti-B antibodies in the plasma which can react with the “A” or “B” antigen of the infant’s blood. So to avoid anti-A & anti-B antibodies in “O” group, plasma should be discarded and the packed RBCs should be transfused.

In case of Rh-negative mother with Rh positive baby, Rh antibody may develop in mother’s blood and Rh antibody may enter into baby’s circulation, in this case the infant should be transfused with Rh-negative blood to avoid Rh antigen & antibody reaction. So for the selection of blood for transfusion in newborn baby up to the age of 4 months mother’s blood group is important to select the appropriate blood.

DOI: http://dx.doi.org/10.3329/jemc.v1i1.11138

J Enam Med Col 2011; 1(1): 36-40