Comment on ABO Incompatibility in Newborns by marybethlambe-8091

Though have been taught since 1980’s that – in ABO incompatibility, the first born child is most likely to manifest sx’s & signs including change in red cells, high bilirubin, etc yet I have never found the likely mechanism for the traditionally understood observation of first born kids most frequently manifest even while overall incidence is low. I also know that recurrence in siblings with same ABO
HAVE >80% risk as well.
As an 0+ mom my own first child had severe reaction in spite of phototherapy developed sx’s & signs of kernicterus w/ low tone, altered reflexes, increased irritability, a strange high pitch cry, altered RBC’s & a bili level over 24. Though exchange began preparations he got better in time to avoid My next 4 A+ kids had no such difficulties and most had only mildest bili elevation. All 5 kids had same homozygous A+ dad. Again, I am aware the first born is not a fast rule as have seen babies who are 2nd, or 3rd etc be the child most impacted.
This site is so very kind and generous. Over the years I have seen endless reviews noting: “ABO HDFN is more common than Rh HDFN and may occur during the first pregnancy.” But then no article goes on to discuss or theorize why this is often true. Would appreciate even a link or reference I can read. I work in medicine & decades have not given me reasons why/ though RH-Neg pregnancies may have worse untreated outcome w/ each subsequent newborn yet ABO tends to go the other way. And it has also been tough to know WHY certain ethnic groups manifest with > incidence & > severity than Caucasian births good luck also learning why, what’s the mechanism? In this later issue find only isolated reports such as “High incidence seen in Jamaican Newborns due to Gut Flora” Thanks a million; great site!

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