In this study, the aim was to assess the effect of ABO and Rh incompatibility on anemia and jaundice in neonates born in a tertiary care hospital in Delhi, India. In our study of 516 neonates, approximately 34.10% of live births were at theoretical risk for immune mediated hemolysis based on ABO and Rh incompatibility, of which 28.29% neonates had mild physiologic jaundice and 0.39% neonates had mild anemia. However, clinical manifestation of pathologic jaundice developed in only 5.81% of at-risk infants with ABO incompatibility, of which 3.68% neonates had TSB between 12mg/dL to 17.99mg/dL and 2.13% neonates had TSB between 18mg/dL to 26mg/dL. All the neonates with TSB more than 18mg/dL were also associated with early onset neonatal sepsis. The incidence of ABO incompatibility with early onset neonatal sepsis with hyperbilirubinemia with severe anemia and severe hemolysis was about 0.2% in our study. Besides, no neonate had hydrops fetalis, kernicterus or cerebral palsy and the neonatal mortality rate was zero, in our study. Thus, in our study, the effect of ABO and Rh incompatibility on anemia and jaundice was mild in most neonates and the effect became severe in presence of risk factors, most commonly neonatal sepsis.
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