To determine if selective newborn cord blood testing (NCBT) could contain costs without increasing morbidity of hemolytic disease of the newborn (HDN).
A national telephone survey confirmed the common practice of routine blood type and Coombs'NCBT.
Two 12-month study arms, retrospective and prospective, were conducted.
Hemolytic disease of the newborn was studied retrospectively under an unrestricted NCBT policy.
Then, HDN was studied after a policy change that restricted NCBT to patients in newborn intensive care units and normal newborns with clinical jaundice or Rh-negative mothers, and/or positive maternal antibody screenings, or unavailable maternal blood testing.
Outcome Measures :
Blood type and Coombs'NCBT, maternal blood type and antibody screening, Hobel risk scores for clinical severity of newborn hospitalization, duration of hospitalizations, and peak serum bilirubin levels.
No quantitative or qualitative increases in morbidity from jaundice were detected by retrospective analysis with unrestricted NCBT, or prospectively after selective testing on 4498 newborns.
Each study arm resulted in 15 readmissions for jaundice ; these included two patients with ABO HDN.
Selective NCBT decreases the use of resources and costs without apparent additional patient morbidity from HDN.
Mots-clés Pascal : Biologie clinique, Sang, Cordon ombilical, Groupage, Exploration immunologique, Anticorps, Indication, Systématique, Etude critique, Prévention, Anémie hémolytique, Nouveau né, Homme, Ohio, Etats Unis, Amérique du Nord, Amérique, Morbidité, Economie santé, Hémopathie
Mots-clés Pascal anglais : Clinical biology, Blood, Umbilical cord, Grouping, Immunological investigation, Antibody, Indication, Taxonomy, Critical study, Prevention, Hemolytic anemia, Newborn, Human, Ohio, United States, North America, America, Morbidity, Health economy, Hemopathy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0565664
Code Inist : 002B20G02. Création : 01/03/1996.