Before transfusing blood in a newborn, we have to understand the basic physiology and unique features of newborn blood groups. This presentation aims to simplify the same.

1. Blood group selection
in Newborn
Dr Padmesh V
DM Neonatology

3. Ag
Ag
Ag
Ag
Ag
Ag
Ag
Ag
Ab
Ab
Ab
Ab
Ab
Ab
Antigens are present in Red Blood Cells
Antibodies are present in Plasma

5. Ag
Ag
Ag
Ag
Ag
Ag
Ag
Ag
Ab
Ab
Ab
Ab
Ab
Ab
ABO antibodies found in the baby’s blood are actually from the mother
through placental transfer.

6. • ABO antigen is fully developed at birth- starts developing at
5-6 weeks of intrauterine life.
• But ABO Antibodies are formed only after 3-4 months of
age.
• Hence, the ABO antibodies found in the baby’s blood are
actually from the mother through placental transfer.
• So, blood group of the baby is tested by ABO Antigen
testing only (forward testing), and Antibody grouping
(reverse grouping) is not required.
• Cross matching of mother’s blood with the donor blood
should be done till 3-4 months.

7. Ag
Ag
Ag
Ag
Ag
Ag
Ag
Ag
DONOR
RBC

8. Ab
Ab
Ab
Ab
Ab
Ab
Ag
Ag
Ag
Ag
Ag
Ag
Ag
Ag
DONOR
RBC
Major Cross matching, that is mixing of Donor RBCs with Recipient Serum is
actually done with Mother’s serum. If this is not compatible, there are chances
of transfusion reactions.

9. • If Mother : O group, there will be Anti-A and Anti-B
IgG, that’ll cross placenta and enter fetal blood.
• So now newborn blood will have Anti-A and Anti-B
antibodies.
• If Newborn’s blood is A, and we transfuse the same
group, the donor RBCs can react with newborn’s
maternal Antibodies and cause transfusion reaction.

10. • In case of transfusing a different ABO group to the
newborn, it is preferable to transfuse PRBC rather
than whole blood, because whole blood contains
Antibodies in the serum.

11. • If mother’s blood group differs from baby’s blood
group, even transfusion of baby’s own blood group
can cause reactions.
• Hence, mother’s blood group should always be
considered for transfusion of the newborn.

12. • Most ABO antibodies are IgM type.
• However, O blood group has both anti-A and anti-B
of IgM and IgG types.
• Rh antibodies are also IgG type.
• IgG can cross placenta and enter fetal blood.
• These IgG ABO antibodies are also immune
antibodies and are stimulated by pregnancy or
transfusion.
• So, the antibodies found in newborn blood at birth
are of maternal origin, and hence maternal serum
should also be cross matched with donor RBCs.

13. • CROSS MATCHING:
• 1.FORWARD CROSS MATCHING (RBC - Ag)
• 2.REVERSE CROSS MATCHING (SERUM – Ab)
• In newborns, reverse cross matching is not done
because their own Antibodies are too low to be
detected.

14. • CROSS MATCHING:
• 1.MAJOR CROSS MATCH: Donor RBC (Ag) with
Patient Serum (Ab)
• 2. MINOR CROSS MATCH: Patient RBC (Ag) with
Donor Serum (Ab)

18. https://www.neonatologyforu.in/