Comparing Neurodevelopmental Outcome among Neonates with Jaundice Due to ABO and Rh Incompatibility.

OBJECTIVES: Evaluating risk factors is essential in the context of hyperbilirubinemia and its clinical outcomes, particularly when attributed to its primary causes: maternal-fetal ABO and Rh incompatibility. This study aims to determine the prevalence rate of predisposing factors and complications of hyperbilirubinemia in newborns with ABO blood group incompatibility, compared to those with Rh incompatibility. MATERIALS & METHODS: This is a descriptive-analytical study. The newborns with jaundice who were referred to Ghaem Teaching Hospital affiliated to the Mashhad University of Medical Sciences, Mashhad, Iran, from 2017 to 2019, divided into two groups of ABO incompatibility (n = 83) and Rh incompatibility (n = 81). The neurodevelopmental assessment was performed by Denver Developmental Screening Test II (DDST-II). Following that, a comparison was made between these two groups. RESULTS: The mean age of the ABO incompatibility group was 5.84 days and the Rh incompatibility group was 4.91 days at admission time. The mean values of bilirubin level obtained at 28.26 ± 5.9 and 30.17 ± 8.19 in newborns with ABO and Rh incompatibility (P = 0.089). No significant difference was observed between the two groups regarding age, Apgar score, bilirubin level (P > 0.05), delivery type (χ2 = 1.56; P = 0.21), and gender (χ2 = 0.403; P = 0.52). Among the study population, 45.8% and 89.1% of the infants with Rh incompatibility and with ABO incompatibility had a near-normal neurological development in the first three years of life. A significant difference was found between the two groups regarding developmental status (χ2 = 25.13; P < 0.05). CONCLUSION: Despite similar bilirubin levels and treatment approaches, neonates with Rh incompatibility experienced significantly higher rates of developmental delay compared to those with ABO incompatibility. By age three, moderate to severe delays were more frequent in the Rh group, underscoring the greater neurodevelopmental risk associated with Rh-mediated hemolysis.