Distribution of ABO, Rhesus Factor Blood Phenotype and Haemoglobin Genotype among Antenatal Clinic Attendees in Anyigba, North Central Nigeria

Background: In the practice of obstetrics and gynecology, the ABO and Rhesus factor (Rh) blood type are important. Blood typing for blood transfusion of compatible blood is very common in emergency and routine care. There is a scanty literature on the distribution of ABO and Rhesus blood types in Anyigba, (North central) Nigeria. Objective: This study aims to determine the distribution of ABO blood and Rhesus blood group phenotypes and Hemoglobin genotypes among antenatal clinic attendees in a teaching hospital. Methods: Antenatal records of attendees (October 2017 to September 2020) at the Kogi State University Teaching Hospital were retrieved and results of antenatal hematological investigations were collected using a structured tool.Bio data, ABO blood group, Rhesus group phenotype and Hemoglobin genotype were collected, inputted and analyzed using SPSS version 20. Results: The mean age was 26 +/- 7years, blood group O is most prevalent,561 (53.6%) then A 276 (26.4%), B 189 (18.1%) and AB,21 (2%).1014 (96.4%) were Rhesus D positive, 33 (3.1%) were Rhesus D negative. For hemoglobin genotype, 786 (75.1%) were AA, 258 (24.6%) were AS, AC were 3 (0.3%). Conclusion: The distribution of the ABO, the Rhesus (D) blood groups and hemoglobin genotypes are in concurrence with the findings of previous studies; Blood group O is the most prevalent and AB the least prevalent, Rhesus (D) positive in the population is high and the hemoglobin genotype AA is the most prevalent. There is no association between blood group phenotypes studied and the hemoglobin genotypes.

Rhesus Negative Pregnancy: Prevalence and Foetomaternal Outcomes in a Tertiary Hospital, South-South Nigeria

Rhesus incompatibility can pose a problem in pregnancy and cause obstetric failure in a handful of women. The Rhesus factor is a red blood cell surface antigen; and there are many antigen subtypes that make up the Rhesus blood group systems, of which the most commonly involved and most immunogenically associated with Rhesus isoimmunisation is the D antigen. The objective of this study is to determine the prevalence of Rhesus negativity and the foetomaternal outcomes at the Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. This was a 5-year retrospective study conducted between 1st January, 2016 and 31st December, 2020 at our Obstetric Unit. Data were retrieved, entered into a pre-designed preformed and analyzed using SPSS version 25.0. Results were presented as mean and standard deviation for continuous variables and frequencies or percentages for categorical variables. Of the 4,571 pregnant women, 104 were Rhesus negative, giving a rate of 2.27%. The most common blood group among the women (53.8%) and their partners (84.6%) was the O blood group. Only 2 (1.9%) women were sensitised. Out of the 104 Rhesus negative women, 81 were unsensitised (77.9%) and received anti-D immunoglobulin. Majority of the babies had a good outcome, though 19 (18.2%) of them were admitted into the special care baby unit for various conditions. The incidence of Rhesus negative pregnancy in our study was 2.27%, and 1.9% of the women were sensitised. Prompt administration of anti-D immunoglobulin after sensitising events and post-delivery is key in the prevention of Rhesus isoimmunisation.

History of the Rhesus factor and of neonatal jaundice

The history of icterus and neonatal jaundice has been recorded since the 17th century, when a French midwife first described jaundice (jaune) in twins. In 1940, Alexander Wiener and Karl Landsteiner discovered the Rh blood group, and they investigated the isoimmunization via antigen transfer across the placenta from the fetus. Other blood group systems implicated in isoimmunization were discovered between 1901 and 1965. Between 1940-1960, many studies have focused on the etiology of hemolytic disease of the newborn, on incompatibility in the Rh system, cholestasis, metabolic diseases, inhibitors of breast milk, and the association between prematurity and jaun-dice or extremely nuclear jaundice. It is the merit of AW Liley, in 1963, who described the diagram of the same name based on the level of bilirubin in the amniotic fluid and who performed the first fetal transfusions for fetal anemia. Last decades, non-invasive methods of diagnosis and treatment were described.

Systematic review and meta-analysis of the effect of ABO blood group on the risk of COVID-19 infection

We have been experiencing a global pandemic with baleful consequences for mankind, since the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was first identified in Wuhan of China, in December 2019. So far, several potential risk factors for SARS-CoV-2 infection have been identified. Among them, the role of ABO blood group polymorphisms has been studied with results that are still unclear. The aim of this study was to collect and meta-analyze available studies on the relationship between SARS-CoV-2 infection and different blood groups, as well as Rhesus state. We performed a systematic search on PubMed/MEDLINE and Scopus databases for published articles and preprints. Twenty-two studies, after the removal of duplicates, met the inclusion criteria for meta-analysis with ten of them also including information on Rhesus factor. The odds ratios (OR) and 95% confidence intervals (CI) were calculated for the extracted data. Random-effects models were used to obtain the overall pooled ORs. Publication bias and sensitivity analysis were also performed. Our results indicate that blood groups A, B and AB have a higher risk for COVID-19 infection compared to blood group O, which appears to have a protective effect. An association between Rhesus state and COVID-19 infection could not be estabished.

Suitability of Placental Blood Samples of Newborns for Pre-Transfusion Testing

Objective: To show concordance between heel stick and placental blood sample pairs for newborns' pre-transfusion testing and to validate placental blood's tube and gel methodology.Methods: Placental samples were collected for pre-transfusion testing at birth from 78 singleton and twin newborns admitted to our Mother–Baby Unit to compare with the results of heel stick samples taken from same newborns. Gestational age ≥35 weeks, weight ≥2,000 g. The study was approved by the Institutional Review Board (IRB). Informed consent was obtained from newborn parents. ABO blood group, Rhesus factor (Rh), direct antiglobulin test (DAT), and antibody screen were performed. Ortho ProVue Analyzer was used for tube and gel methods. McNemar's test for paired categorical data was performed.Results: One hundred percent concordance in 78 pairs for ABO and Rh. Seventy-four pairs were tested for antibodies, 72 were both negative, 1 was both positive, and 1 gave discordant result. Ninety-nine percent concordance, p = 0.999. Sixty-five pairs were both DAT negative, seven were both DAT positive, and six gave discordant results. Ninety-two percent concordance, p = 0.68. Placental blood gave identical results comparing tube with gel methods.Conclusions: Placental blood is suitable for pre-transfusion testing and can replace heel sticks. Placental blood tube and gel methods are validated.

The Relation between the Blood Groups, Rhesus Factor, and Breast Cancer in the Holy Karbala Governorate

The distribution ABO blood groups among patients with breast cancer were as follow: blood group type O (40.8%), blood group type A (25.0%), B (23.7%), and AB (10.4%), for the donor’s healthy control, ABO blood groups percentages were as follow: type O (39.9%) type A (28.1%), type B (22.0%), and type AB (9.9%). There is no significant association between blood types ABO and the breast cancer. (P > 0.05) Rh factor has a significant difference between patients with breast cancer and healthy control (P=0.002). There were significant differences in age categories among patients with breast cancer and controls. (p= 0.000) .

An Evaluation of Antenatal Screening Services Provided in Health Facilities of Lundazi District, Zambia

Background: Provision of quality Antenatal care requires holistic screening and timely treatment to prevent neonatal and maternal mortalities. Methods: A facility based cross- sectional study evaluated antenatal screening services offered in Lundazi District, Zambia. The study was conducted between October 2019 and June2020. Study units comprised 5 health facilities, 60 ANC mothers and 75 ANC providers. The study used facility audit, observation and self-administered questionnaires. Results: The study found that ANC mothers could not be weighed in all the health facilities due to dysfunctional weighing scales. Facilities lacked Multistix for urine testing. Facilities could not test for blood grouping or screen blood for Rhesus factor. One facility could not screen for HIV and Malaria as reagents were out of stock. Another facility could not screen Haemoglobin levels for anaemia as the Hamacue machine was dysfunctional. Routine ultrasound was not done in all the five facilities. Conclusion: Lack of functional equipment and essential supplies used for screening ANC mothers for any abnormality is a significant missed opportunity for early diagnosis and timely treatment of medical conditions. Reinforcing this component improves provision of quality antenatal care. Therefore, increased Antenatal care coverage requires a simultaneous scale-up of ANC equipment, supplies and drugs.

Correlation between ABO Blood Groups and Disease Severity and Mortality in Hospitalized COVID-19 Patients

Introduction After appearance of the novel Coronavirus 2019 in Wuhan, China, new epicenters of the now pandemic appeared nationally. The new Coronavirus disease 2019 (COVID-19) is associated with a syndrome of acute hypoxemic respiratory failure that can lead to admission to intensive care unit (ICU), invasive mechanical ventilation, and at times, death. The first two COVID-19 cases in the State of Michigan were reported in March 10, 2020. During the subsequent weeks, Michigan became one of the early national epicenters of the current COVID-19 pandemic. Early observational studies have suggested a correlation between susceptibility to COVID-19 infection and type A blood group, and furthermore, increased risk of respiratory failure and worse outcome. We conducted this retrospective study to evaluate the association between ABO blood groups and disease severity/mortality in hospitalized COVID-19 patients. Methods We reviewed the records of hospitalized patients with PCR-confirmed COVID-19 testing managed at Henry Ford Health System (HFHS) between March 10 and April 30, 2020. Henry Ford Health System (HFHS) serves inner city and metropolitan Detroit in Michigan, with diverse demographics including African American, Middle Eastern, and Caucasian populations. Age, gender, race, ABO blood groups, comorbidities, disease severity (defined as intensive care unit admission), intubation, and mortality variables were collected for 1488 eligible patients. Survival data was updated on July 15, 2020. Results were presented as median plus range, or percentages as indicated. In the univariate analysis, Student's t-test and Pearson's Chi-square/Fisher's exact test were used to determine the significance and odds ratio (OR) for the independent variables as related to outcome. A multivariate analysis was performed using logistic regression to identify the risk factors for mortality. A backward stepwise (Wald) selection model was performed, with significance level for removal from the model set at 0.1. All tests of significance were two-sided, and a p value of < 0.05 was regarded as significant. All statistical analyses were performed using SPSS (Statistical Package for Social Sciences) software, version 22 (SPSS Inc., Chicago, IL, USA). This study was approved by the Institutional Review Board of HFHS. Results 1488 hospitalized COVID-19 positive patients with available ABO blood group were included. The median age of patients was 68 years (Range 19-99 years); 801 (54%) were females. Most patients (n=856; 58%) were African Americans. 485 (32.6%) patients had blood group A, 276 (18.5%) had group B, 658 (44.2%) had group O, and 69 (4.6%) had group AB. 469 (31.5%) patients required ICU admission, 370 of whom were intubated. On last follow up, 411 (27.6%) patients were dead. ABO blood groups and Rhesus factor (D antigen) were not associated with the ICU admission, intubation, or mortality. Male gender, age ≥65 years, some underlying diseases such as obesity, coronary artery disease chronic obstructive pulmonary disease and malignancy were associated with increased mortality. African American patients were almost 40% less likely to die (OR = 0.56; 95% CI: 0.44-0.7; p < 0.001). Table 1 shows the parameters analyzed as predictors of mortality using univariate and multivariate logistic regression. Multivariate analysis showed that age (≥65 years) (OR = 4.27; 95% CI: 3.19-5.71; p < 0.001), male gender (OR = 1.57; 95% CI: 1.23-2.01; p < 0.001), Caucasian race (OR=1.46; 95% CI: 1.14-1.86; p = 0.003), and COPD (OR = 1.49; 95% CI: 1.09-2.04; p = 0.013) were associated with mortality. Conclusion According to our study, ABO blood groups and Rhesus factor did not correlate with disease severity, use of mechanical ventilation, or mortality in hospitalized COVID-19 patients. Elderly patients, male gender, patients with COPD were at increased risk of death. Contrary to perceived belief, African Americans were not at increased risk of mortality, compared to Caucasians with COVID-19 infection. Caucasians were more likely to die from COVID-19 infection. Disclosures No relevant conflicts of interest to declare.