Maternal ABO blood group and adverse pregnancy outcomes

ABO blood groups are not associated to gestational diabetes mellitus in Mexican women

OBJECTIVES

Some studies show an increased risk of gestational diabetes mellitus for ABO blood groups. Others find a lower risk or do not identify any association. Inconsistencies may be due to the heterogeneity in the control for confounding variables. We determined the association between ABO blood groups and gestational diabetes mellitus in Mexican women, controlling for gravidity and age, pre-pregnancy body mass index, fasting glucose at the first trimester, and first-degree relative with diabetes.

METHODS

This case-control study was conducted from February 2019 to December 2021 in Monterrey, Mexico, with 185 cases (women with gestational diabetes mellitus) and 530 controls. ABO blood groups and other variables were obtained from the clinical records. A multivariate binary logistic regression was used for estimating association. Two models were run, one for primigravidae and another for non-primigravidae. A p-value < 0.05 was significant.

RESULTS

The ABO blood groups were O (69.4%), A (22.2%), B (6.7%), and AB (1.7%), with no differences between cases and controls (p = 0.884). No association was found between ABO blood groups and gestational diabetes mellitus, in primigravidae or non-primigravidae.

CONCLUSION

ABO blood groups were not associated with an increased risk of gestational diabetes mellitus in Mexican women, independent of gravidity and well-known risk factors.

Blood Type and Outcomes in Pregnant Women with Placenta Previa

Background

Placenta previa increases the risks of obstetrical complications. Many studies have reported a link between various ABO blood types and pregnancy complications. This study is aimed at describing and comparing the characteristics and outcomes of women with placenta previa by ABO blood type.

Methods

Data for this study was obtained from a retrospective cohort study between January 1, 2014, and June 30, 2019, of all clinically confirmed placenta previa in a university-based tertiary medical center. Both types of A, B, O, AB, and combining O and non-O blood types were compared to the characteristics and outcomes.

Results

1678 participants with placenta previa were included in this study. The highest participants were blood type O with 666 (39.7%), followed by type A with 508 (30.3%) and type B with 395 (23.5%), and the lowest participants were AB with 109 (6.5%). Blood type AB had a higher incidence of antepartum hemorrhage (p = 0.017), predelivery anemia (p = 0.036), and preterm birth (p = 0.015) in placenta previa women. Meanwhile, the incidence of rhesus D positive (97.9% vs. 95.8%, p = 0.012) and twins (5.0% vs. 2.7%, p = 0.011) was higher in the non-O group, and the incidence of neonatal asphyxia (5.9% vs. 9.2%, p = 0.016) was lower in the non-O group.

Conclusion

Type AB blood may be a potential risk factor for women with placenta previa. This finding may help provide any obstetrician to predict the risk of complication for placenta previa women by the ABO blood types.

The impact of maternal ABO blood type on obstetric and perinatal outcomes after frozen embryo transfer

RESEARCH QUESTION

Does the maternal ABO blood type affect obstetric and perinatal outcomes following frozen embryo transfer (FET)?

DESIGN

A retrospective study was performed at a university-affiliated fertility centre, involving women with singleton and twin deliveries conceived by FET. Subjects were divided into four groups based on ABO blood type. The primary end-points were obstetric and perinatal outcomes.

RESULTS

A total of 20,981 women were involved, with 15,830 having singletons and 5151 delivering twins. In singleton pregnancies, women with blood group B had a slight but significantly increased risk of gestational diabetes mellitus compared to women with blood group O (adjusted odds ratio [aOR] 1.16; 95% confidence interval [CI] 1.01-1.34). Furthermore, singletons born to women with the B antigen (blood type B or AB) were more likely to be large for gestational age (LGA) and with macrosomia. In twin pregnancies, blood type AB was related to a decreased risk of hypertensive diseases of pregnancy (aOR 0.58; 95% CI 0.37-0.92), while blood type A was associated with a higher risk of placenta praevia (aOR 2.04; 95% CI 1.15-3.60). When compared with the O blood group, twins from the AB blood group had a lower risk of low birthweight (aOR 0.83; 95% CI 0.71-0.98) but a higher risk of LGA (aOR 1.26; 95% CI 1.05-1.52).

CONCLUSIONS

This study demonstrates that the ABO blood group may influence the obstetric and perinatal outcomes for both singletons and twins. These findings emphasize that patient characteristics could be, at least partly, responsible for adverse maternal and birth outcomes following IVF.

Association Between ABO Blood Group and Gestational Diabetes Mellitus in Pregnant Women at King Abdulaziz University Hospital: A Retrospective Study

Objective Gestational diabetes mellitus (GDM) can occur during pregnancy. One of the leading causes of it is a hormone produced by the placenta that interferes with glucose absorption and causes glucose buildup in the bloodstream. Genetic variations between ethnicities are believed to be associated with GDM, and there has been some research on the association of ABO blood group with GDM in different populations. However, the results so far are inconsistent, and there is no conclusive evidence on how ABO blood group affects the occurrence of GDM. This study aims to examine the link between ABO blood group and GDM in pregnant women at King Abdulaziz University Hospital. Methodology A retrospective cohort study was conducted on a group of GDM patients between 2019 and 2022 using data collected from the patients' medical records at King Abdulaziz University Hospital. Results The overall prevalence of GDM was high at 74.7%, and the percentage of patients with A, O, B, and AB blood group who had GDM was 42.9%, 41.41%, 12.1%, and 3.59%, respectively. However, there was no significant difference in Rh status or any other clinical characteristic between the participants who had GDM and those who did not have GDM. Conclusion The present findings indicate that blood group is not associated with the development of GDM in this cohort from Saudi Arabia. However, more studies are required in the future to corroborate these findings.

Genes, exposures, and interactions on preterm birth risk: an exploratory study in an Argentine population

Preterm birth (PTB) is the main condition related to perinatal morbimortality worldwide. The aim of this study was to identify associations of spontaneous PTB with genetic variants, exposures, and interactions between and within them. We carried out a retrospective case-control study including parental sociodemographic and obstetric data, and fetal genetic variants. We sequenced the coding and flanking regions of five candidate genes from the placental blood cord of 69 preterm newborns and 61 at term newborns. We identify the characteristics with the greatest predictive power of PTB using penalized regressions, in which we include exposures (E), genetic variants (G), and two-way interactions. Few prenatal visits (< 5) was the main predictor of PTB from 26 G, 35 E, 299 G × G, 564 E × E, and 875 G × E evaluated terms. Within the fetal genetic characteristics, we observed associations of rs4845397 (KCNN3, allele T) variant; G × G interaction between rs12621551 (COL4A3, allele T) and rs73993878 (COL4A3, allele A), which showed sensitivity to anemia; and G × G interaction between rs11680670 (COL4A3, allele T) and rs2074351 (PON1, allele A), which showed sensitivity to vaginal discharge. The results of this exploratory study suggest that social disparities and metabolic pathways linked to uterine relaxation, inflammation/infections, and collagen metabolism would be involved in PTB etiology. Future studies with a larger sample size are necessary to confirm these findings and to analyze a greater number of exposures.

Maternal bleeding complications in pregnancies affected by red blood cell alloimmunization

OBJECTIVE

To investigate whether women with red blood cell (RBC)¹ alloimmunization are more likely to experience bleeding complications during pregnancy or delivery than women without RBC alloimmunization.

STUDY DESIGN

Retrospective study involving all singleton pregnancies affected by RBC alloimmunization and without pre-existing maternal bleeding disorders or placenta previa, from 1 July 1999 to 30 June 2019 ("cases"). Only bleedings not related to invasive procedures (amnio- or cordocenteses) were included. Patients who were already at increased risk of pre- or perinatal bleeding due to their medical history (pre-existing bleeding disorders, antithrombotic therapy), or known obstetrics parameters (placental abnormalities etc.) were not included a priori. Cases were compared to controls without RBC alloimmunization, matched for maternal age and body mass index, from the same tertiary referral center in Austria.

RESULTS

130 cases were compared to 130 controls. Cases had significantly more previous pregnancies and miscarriages and their newborns had lower birthweight and were more often transferred to the intensive care unit than newborns of controls. 18/130 (13.8%) cases, compared to 8/130 (6.2%) controls experienced any bleeding during pregnancy or delivery (p = 0.061). Bleeding most often happened during the third trimester (cases: 4.6% vs. controls 0.8%, p = 0.12) and during or after delivery (cases: 7.7% vs. controls: 4.6%, p = 0.168). Binary logistic regression for the prediction of any bleeding complication during pregnancy, delivery or postpartum revealed immunization against RBC antigens as the only independent contributor (p = 0.04). Age, smoking, or previous obstetric history had no influence on the likelihood of maternal bleeding complications. Neither RBC antibody specificity nor titers were predictive of maternal bleeding during pregnancy or delivery.

CONCLUSION

Pregnancies affected by RBC alloimmunization might be at increased risk of maternal bleeding complications during pregnancy and delivery.

Is the Development of Gestational Diabetes Associated With the ABO Blood Group/Rhesus Phenotype?

AIMS

There are few published data on the putative association between the ABO blood group/rhesus (Rh) factor and the risk of developing gestational diabetes mellitus (GDM). Our aim was to explore the link between each one factor and GDM development.

METHODS

All women having given birth at Lille University Medical Center (Lille, France) between August 1^st, 2017, and February 28^th, 2018, were tested for GDM, using the method recommended in the French national guidelines. The risk of GDM was assessed for each ABO blood group, each Rh phenotype and combinations thereof, using logistic regression models.

RESULTS

1194 women had at least one GDM risk factor. The percentage of GDM varied with the ABO group (p=0.013). Relative to group O women, group AB women were more likely to develop GDM (OR = 2.50, 95% CI [1.43 to 4.36], p=0.001). Compared with the Rh-positive O group, only the Rh-positive AB group had an elevated risk of developing GDM (OR = 3.02, 95% CI [1.69 to 5.39], p < 0.001).

CONCLUSIONS

Our results showed that Rh-positive group AB women have a greater risk of GDM. With a view to preventing GDM, at-risk individuals could be identified by considering the ABO blood group phenotype either as a single risk factor or in combination with other risk factors.

The association between ABO blood groups and gestational diabetes mellitus: a retrospective population-based cohort study

OBJECTIVE

There is a lot of evidence that connects blood type to several diseases, including the development of diabetes mellitus type 2. The evidence for an association between ABO blood groups and the possibility of developing gestational diabetes mellitus (GDM) is scant and inconclusive. We aimed to examine the link between ABO blood group types and GDM by the use of a large population-based cohort of pregnant women.

STUDY DESIGN

A retrospective population-based cohort study was conducted using data collected from January 2013 to December 2017 from the Emek Medical Center, Afula, Israel. All pregnant women who underwent the two-step screening and diagnosed with GDM and delivered at >24 weeks were included. Women who had pre-gestational diabetes or whose pregnancies were terminated were excluded. The odds ratio (OR) were obtained through binary logistic regression analysis and the corresponding 95% confidence interval (CI) by the use of both the univariable and multivariable analysis.

RESULTS

Of all 16,067 women included in the study cohort, 1712 (10.7%) had GDM. The incidence of GDM was 11.0%, 10.8%, 10.6%, and 8.8% in blood group A, B, O, and AB, respectively. After adjusting for maternal age, parity, and number of fetuses, AB blood group was associated with reduced risk for developing GDM compared to the other blood groups (p = .038; adjusted OR: 0.79; 95% CI: 0.64-0.99). There was no difference in Rhesus factor between GDM and controls.

CONCLUSIONS

Women with AB blood group have a lower risk for developing GDM compared to other blood group types.

The Association Between ABO Blood Group and Preeclampsia: A Systematic Review and Meta-Analysis

Objective: This meta-analysis comprehensively evaluated the association between ABO blood group and the risk of preeclampsia (PE).

Design: Systematic review and meta-analysis.

Data sources: PubMed, Web of Science, and ScienceDirect databases from their inception to September 23, 2020.

Methods: Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were obtained through random-effects and fixed-effects models according to heterogeneity. Meta-regression analysis was applied to explore the source of heterogeneity. We conducted a subgroup analysis by the publication year, study design, state, and Newcastle-Ottawa Scale (NOS) score. In addition, we calculated the rate of each ABO blood group in PE by total pooled effects.

Results: A total of 12 articles with 714,153 patients were included in our analysis. Compared with people without PE (control group), the O blood group presented a lower risk of PE (OR 0.95, 95% CI 0.93–0.97). The AB (OR 1.46, 95% CI 1.12–1.91) blood group presented a higher risk. However, the total pooled OR and 95% CI for the A (OR 1.02, 95% CI 0.90–1.16) and B (OR 1.02, 95% CI 0.98–1.05) blood groups were not significant. The funnel plot and linear regression equation showed that there was no publication bias for the O, A, or B blood groups (all P > 0.05). However, the funnel plot and linear regression equation for the AB blood group were obviously asymmetric (P < 0.05), and the publication bias persisted even after the trim-and-fill method was applied (P < 0.05). Multivariable meta-regression analysis did not find a specific source of heterogeneity. The A blood group showed an association with early-onset PE (OR 0.53, 95% CI 0.33–0.83), and the other blood groups showed no significant differences. In PE, the rates of the O, A, B, and AB blood groups decreased gradually (0.39, 0.33, 0.19, 0.07).

Conclusion: These findings suggest that pregnant women with AB blood group are more likely to develop PE, and more attention should be paid to AB blood group whose blood pressure is high but not sufficient to diagnose PE.

Systematic Review Registration: Prospero CRD42021227930.

Relationship between ABO blood group and gestational diabetes mellitus: A protocol for systematic review and meta-analysis

BACKGROUND

Gestational diabetes mellitus (GDM) is a common metabolic disorder syndrome in women during pregnancy. If effective measures are not taken to intervene in the early stage of GDM, severe effects will damage maternal and infant health. ABO is the most important human blood group system. A large number of studies have displayed that ABO blood group is associated with many diseases. At present, the risk relationship between ABO blood group and GDM is controversial. The purpose of this study is to explore the risk relationship between ABO blood group and GDM by meta-analysis, thus providing basis for the prevention and treatment of GDM.

METHODS

An electronic database, including Embase, Cochrane Library, Pubmed, Chinese databases SinoMed, Chinese National Knowledge Infrastructure, Chinese Scientific Journals Database and Wanfang Data, will be used to search for studies of ABO blood group and GDM. The language will be limited to Chinese and English. The two reviewers will be responsible for the selection of the study, the extraction of data and the evaluation of the quality of the research. All statistical analyses will be carried out using Review Manager 5.3.

RESULTS

The results of this meta-analysis will be published in peer-reviewed journals.

CONCLUSION

This study will provide evidence to support the relationship between ABO blood group and the risk of GDM.

ETHICS AND DISSEMINATION

The private information from individuals will not be published. This systematic review also will not involve endangering participant rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/W6QSX.

Relationship between ABO blood groups and gestational hypertensive disorders: A protocol for systematic review and meta-analysis

BACKGROUND

The distribution of ABO blood group is related to the incidence of various diseases. Gestational hypertensive disorders (GHD) is one of the most important risk factors during pregnancy, which has certain heredity. It is reported that ABO blood type is associated with the risk of GHD. However, the results are still controversial. In this study, we conducted a systematic review and meta-analysis to clarify the relationship between ABO blood group and GHD.

METHODS

All eligible studies come from Embase, Cochrane Library, Pubmed, Chinese databases SinoMed, Chinese National Knowledge Infrastructure, Chinese Scientific Journals Database, and Wanfang Data. The retrieval time is from the establishment of the database to March 2021. The language will be limited to Chinese and English. The 2 reviewers will be responsible for the selection of the study, the extraction of data, and the evaluation of the quality of the research. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the corresponding associations. Sensitivity analysis, publication bias assessment, and heterogeneity test were performed using STATA 16.0.

RESULTS

The results of this meta-analysis will be published in peer-reviewed journals.

CONCLUSION

This study will provide evidence to support the relationship between ABO blood group and the risk of GHD.

ETHICS AND DISSEMINATION

The private information from individuals will not be published. This systematic review also will not impair endangering participants' rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/3X9YZ.

Frequency of ABO Blood Group in Pregnant Women and Its Correlation With Pregnancy-Related Complications

Introduction

The ABO blood group type has been considered an independent risk factor in the occurrence of pregnancy-related complications leading to significant morbidity and mortality in pregnant mothers and neonates. This study aims to determine the maternal ABO blood group and its correlation with pregnancy-related complications.

Methods

We analysed data of 497 pregnant female patients aged between 25 and 40 years who presented with a gestational age of > 14 weeks from June 1, 2020, to November 30, 2020. Patients’ age, parity, gestational age at the first visit, body mass index (BMI) at the first visit, ABO blood group, gestational age at delivery, mode of delivery, birth weight of neonate, and pregnancy-related complications including preeclampsia, gestational diabetes mellitus (GDM), preterm delivery, low birth weight (LBW), and small for gestational age (SGA) infants were evaluated.

Results

The mean age of 497 patients was 27.6 (27.62 ± 3.35) years. Mean BMI was 22.7 (22.7 ± 3.1 kg/m²), parity was 1.85 (1.85 ± 2.3), gestational age at first visit was 23.19 (23.19 ± 3.4) weeks and gestational age at delivery was 37.0 (37.0 ± 2.6) weeks. There were 205 (41.25%) spontaneous vaginal delivery and 292 (58.75%) cesarean sections. The average birth weight of the neonate was 2684.31 ± 622.4 g. Preeclampsia was observed in 107 (21.53%), GDM in 17 (3.42%), and preterm delivery in 154 (30.99%) women. Considering the neonatal outcome, 124 (24.95%) babies had LBW and 49 (9.86%) were SGA. The rate of preeclampsia and GDM was not statistically significant among different blood groups while the rate of preterm delivery, LBW, and SGA was significant among women with different blood groups.

Conclusion

We conclude that the ABO blood group is associated with maternal and neonatal pregnancy-related complications when considering the risk of preterm delivery, LBW, and SGA but not with GDM and preeclampsia. This finding will help clinicians to identify the patients at risk of developing pregnancy-related complications and hence, to take timely and appropriate measures.

Evaluation of maternal rhesus blood type as a risk factor in adverse pregnancy outcomes in Korea: a nationwide health insurance database study

OBJECTIVES

The current study aimed to investigate whether pregnancy outcomes are affected by maternal rhesus (Rh) status by comparing the primigravida pregnancy outcomes of Rh-negative women with those of Rh-positive women.

METHODS

The study data were collected from the Korea National Health Insurance Claims Database and the National Health Screening Program for Infants and Children. In total, 1,664,882 primigravida women who gave birth between January 1, 2007 and December 31, 2014, were enrolled in this study. As the risk and severity of sensitization response increases with each subsequent pregnancy, only primigravida women were enrolled. The patients were divided into 2 groups according to Rh status, and the pregnancy outcomes were compared.

RESULTS

In total, 1,661,320 women in the Rh-positive group and 3,290 in the Rh-negative group were assessed. With regard to adverse pregnancy outcomes, there was no statistically significant difference between the 2 groups in terms of the prevalence of preeclampsia, postpartum hemorrhage, abruptio placenta, placenta previa, and uterine artery embolization. A univariate analysis revealed that none of the adverse pregnancy outcomes were significantly correlated to Rh status (preeclampsia: odds ratio [OR], 1.00, 95% confidence interval [CI], 0.81-1.23; postpartum hemorrhage: OR, 1.10, 95% CI, 0.98-1.24; abruptio placenta: OR, 0.80, 95% CI, 0.46-1.37; and placenta previa: OR, 1.08, 95% CI, 0.78-1.42). The adjusted ORs of postpartum hemorrhage and preterm birth did not significantly differ.

CONCLUSION

Maternal Rh status is not associated with adverse outcomes in primigravida women.

Relationship between ABO blood groups and preeclampsia

OBJECTIVE

To investigate the relationship between ABO blood group and preeclampsia.Methods: A case-control study was conducted, including 230 and 460 women with and without preeclampsia. ABO blood groups were compared and associated factors for preeclampsia were determined.Results: Blood group O was significantly more common in early-onset and less common in late-onset preeclampsia. Regression analysis showed that blood group O decreased the risk of late-onset preeclampsia (aOR 0.63, 95%CI 0.42-0.93) but increased the risk of early-onset preeclampsia (aOR 1.97 95%CI 1.05-3.69).Conclusion: Blood group O decreased the risk of late-onset preeclampsia while it increased the risk of early-onset preeclampsia.

Recurrent Placental Transcriptional Profile With a Different Histological and Clinical Presentation: A Case Report

Statistically, patients with severe pregnancy complications are at risk of recurrent complications, but it is less understood if patients present with similar or different placental pathologies in subsequent pregnancies. In this case report, we describe 2 consecutive adverse pregnancies in the same woman 4 years apart. The first pregnancy was diagnosed as early-onset preeclampsia and hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, with placental maternal vascular malperfusion features, such as syncytial knots and accelerated villous maturity. In contrast, the second pregnancy was associated with normotensive fetal growth restriction and placental "immunological" lesions, such as massive perivillous fibrin deposition and chronic intervillositis. However, based on the expression of FLT1, LIMCH1, and TAP1 by quantitative polymerase chain reaction, the placentas from both pregnancies were found to exhibit an "immunological" transcriptional signature. This suggests that this small panel of gene expression markers may be able to predict the future reoccurrence of an immunological placental pathology despite no histological evidence within the first pregnancy. These results call for more studies looking at paired pregnancies of individuals with recurrent obstetric complications and confirm the importance of assessing matched transcriptional and histopathological placental information.

Relationship between ABO blood group and gestational diabetes mellitus

OBJECTIVE

To investigate the association between the ABO blood group and gestational diabetes mellitus (GDM).

METHODS

A case-control study was conducted in 600 pregnant women who received GDM screening with 50-g GCT and diagnosis by 100-g OGTT according to institutional guidelines. The cases included 200 women with GDM and another 400 normal pregnant women were randomly selected as controls. Various characteristics and ABO blood group were extracted from medical records and compared between cases and controls to determine their association with GDM. Logistic regression analysis was performed to determine independent associated factors for GDM adjusting for potential confounders.

RESULTS

Univariate analysis showed that significant factors associated with GDM were age ≥30 years, family history of DM, overweight, and obesity. Only blood group O significantly increased risk of GDM (OR 1.51, 95% CI 1.06-2.13, p = .020). Logistic regression analysis showed that blood group O independently increased the risk of GDM (adjusted OR 1.99, 95% CI 1.32-3.0, p = .001). The risk of GDM was enhanced in women with blood group O with family history of DM (adjusted OR 3.5, 95% CI 1.57-7.81, p = .002) while it was attenuated among those without (adjusted OR 1.6, 95% CI 0.97-2.64, p = .064).

CONCLUSION

Blood group O independently increased the risk of GDM.

Maternal ABO Blood Type and Factors Associated With Preeclampsia Subtype

BACKGROUND

The pathophysiology of preeclampsia remains unclear. The disorder is heterogeneous, and the pathophysiology may vary by subtype. Identification of relevant biomarkers will help to better elucidate the pathophysiologic basis of each preeclampsia subtype. Blood type may be a biomarker that allows risk identification for preeclampsia.

OBJECTIVE

The purpose of this study was to investigate the associations among maternal ABO blood type and preeclampsia subtype and fetal growth restriction (FGR).

METHOD

Medical records of 126 women with early-onset preeclampsia (≤33 6/7 weeks' gestation), 126 women with late-onset preeclampsia (≥34 0/7 weeks' gestation), and 259 controls who gave birth between January 2012 and June 2016 were retrospectively abstracted from a large suburban tertiary referral center in South Central Pennsylvania for this hospital-based case-control study.

RESULTS

Women with AB blood type had >3 times the odds of late-onset preeclampsia (odds ratio [ OR] = 3.35, 95% confidence interval (CI) = [1.02, 11.05]) compared to those with O blood type. Among women with early-onset preeclampsia, those with B blood type had 5 times the odds of having a growth-restricted fetus than did women with O blood type ( OR = 5.44, 95% CI [1.65, 17.94]).

DISCUSSION

Our findings suggest that AB blood type may be an important risk factor for late-onset preeclampsia and that among women with early-onset preeclampsia, those with B blood type have increased odds of FGR. These findings warrant further study in women and their offspring to identify the pathophysiologic processes that may link ABO blood type, preeclampsia subtype, and FGR.

The association between AB blood group and neonatal disease

BACKGROUND

Numerous studies have examined the association between ABO blood groups and adult disease states, but very few have studied the neonatal population. The objective of this study was to determine the relationship between AB blood group and the occurrence of common neonatal disorders such as neutropenia at birth, sepsis, respiratory distress syndrome (RDS), intraventricular hemorrhage (IVH), retinopathy of prematurity (ROP), and patent ductus arteriosus (PDA) compared to all other blood groups.

METHODS

We performed a retrospective review on 3,981 infants born at 22 0/7 to 42 6/7 weeks' gestational age and compared the relative risk of neonatal diseases in infants with AB blood group to that of infants with all other blood groups (A, B, and O).

RESULTS

When compared to all other blood groups, AB infants demonstrated an increased risk for developing negative clinical outcomes. AB blood group was significantly associated with a 14-89% increased risk of neutropenia at birth, sepsis, RDS, and ROP. Risks for IVH and PDA were not significant.

CONCLUSION

We hypothesize that the phenotypic expression of A and B antigens, rather than the antigens themselves, in the AB group may reveal an enhanced susceptibility to injury at the endothelial level resulting in an increased risk for disease development.

Placental protein 13: An important biological protein in preeclampsia

Placental protein 13 (PP13), a glycan binding protein predominantly expressed in syncytiotrophoblast, dimeric in nature, lacks N-terminal signal peptide, bypasses the endoplasmic reticulum, and secretes into maternal circulation as exosomes or microvesicles. PP13 has jelly roll fold conformation with conserved carbohydrate recognition domain which specifically binds to β-galactosides of the glycan receptors during placentation. PP13 binds to glycosylated receptors on human erythrocytes and brings about hemagglutination by the property of lectin activity; other functions are immunoregulation and vasodilation during placentation and vascularization. The gene LGALS13 located on 19q13.2 comprising four exons expresses a 32-kDa protein with 139 amino acid residues, PP13. Impaired expression due to mutation in the gene leads to a nonfunctional truncated PP13. The low serum levels predict high risk for the onset of preeclampsia or obstetric complications. Hence, PP13 turned to be an early marker for risk assessment of preeclampsia. The recombinant PP13 and monoclonal antibodies availability help for replenishing PP13 in conditions with low serum levels and for detection and prevention of preeclampsia, respectively.

ABO Blood Group and Prevalence of Osteoporosis and Osteopenia in the Elderly Population: An Amirkola Health and Ageing Project (AHAP)-Based Study

Osteoporosis is known as a degenerative disease of the skeletal system and its main complication is fracture, which influences quality of life in the elderly. There are 4 major blood groups in humans based on the presence of A and B antigens. According to the investigations, there are reported relations between blood types and some diseases. In this study, the association between the ABO blood group and the prevalence of osteoporosis and osteopenia in an elderly population was investigated. Medical records of 990 elderly people were investigated in a cross-sectional study and the association between their blood group and the incidence of osteoporosis and osteopenia was analyzed using SPSS version 17.0 (SPSS Inc., Chicago, IL, USA). The results showed that ABO blood groups had no association with the prevalence of osteoporosis in both elderly men and women. The association between age and osteoporosis was significant and the association between this disorder and gender was significant too. The results also indicate that there is no association between RH⁺ and RH^- blood types and osteoporosis and osteopenia in both men and women. Based on this finding, it would be reasonable to conduct extensive studies.

Association between ABO and Rh Blood Groups and Risk of Preeclampsia: A Case-Control Study from Iran

AIM:

Preeclampsia (PE) is a major cause of maternal and neonatal morbidity and mortality. There is a genetic component in the development of PE with estimated heritability around 0.47. Several studies have investigated the association between maternal ABO blood groups (OMIM 110300) and risk of PE, with contradictory results have emerged. Considering that there is no study in this filed from Iranian population, the present case-control study was carried out at Shiraz (south-west Iran).

MATERIAL AND METHODS:

In this study 331 women; 121 pregnant with PE and 210 normotensive pregnant women were included. Using blood group O (for ABO blood groups) or Rh+ (for Rh blood groups) as a reference, odds ratios (ORs) and its 95% confidence intervals (95% CI) of PE risk were estimated from logistic regression analysis.

RESULTS:

Although the A (OR = 0.67, 95% CI = 0.39-1.17, P = 0.165), B (OR = 0.86, 95% CI = 0.48-1.53, P = 0.615) and AB (OR = 1.14, 95% CI = 0.37-3.45, P = 0.812) phenotypes showed lower risks compared with the O blood group, statistical analysis indicated that there was no significant association between ABO phenotypes and risk of PE. The frequency of Rh- phenotype was higher among PE patients compared with the control group. However, the association was not significant (OR = 1.79, 95% CI = 0.69-4.65, P = 0.229). Adjusted ORs for age of participants and parity did not change the above-mentioned associations.

CONCLUSION:

Our present findings indicate that there is no association between ABO and Rh blood groups and risk of PE in Iranian population.

O Blood Group as Risk Factor for Preeclampsia among Sudanese Women

AIM

To investigate blood groups and the other possible risk factors for preeclampsia among Sudanese women.

MATERIAL AND METHODS

A case - control study was conducted at Saad Abualila Hospital, Khartoum, Sudan during the period of July 2013 through December 2014. The cases were women with preeclampsia and healthy pregnant women were the controls.

RESULTS

Two hundred eighty pregnant women were enrolled (140 in each arm of the study). Around one-quarter of all women (280) were primiparae (74.0, 26.4%), the majority were housewives (201, 71.7%). Seventy-nine (28.2%) were illiterate or had no informal education. Around half of the women (130, 46.4%) had O blood group. Binary logistic regression showed association between preeclampsia and lack of antenatal care (OR = 2.75, 95% CI = 1.172-6.494, P = 0.020) as well as O blood group (OR = 1.78, 95% CI = 1.088-2.934, P=0.022).

CONCLUSION

The current study showed that women with blood group O were at higher risk of preeclampsia.

Unsupervised Placental Gene Expression Profiling Identifies Clinically Relevant Subclasses of Human Preeclampsia

Preeclampsia (PE) is a complex, hypertensive disorder of pregnancy, demonstrating considerable variability in maternal symptoms and fetal outcomes. Unfortunately, prior research has not accounted for this variability, resulting in a lack of robust biomarkers and effective treatments for PE. Here, we created a large (N=330) clinically relevant human placental microarray data set, consisting of 7 previously published studies and 157 highly annotated new samples from a single BioBank. Applying unsupervised clustering to this combined data set identified 3 clinically significant probable etiologies of PE: "maternal", with healthy placentas and term deliveries; "canonical", exhibiting expected clinical, ontological, and histopathologic features of PE; and "immunologic" with severe fetal growth restriction and evidence of maternal antifetal rejection. Moreover, these groups could be distinguished using a small quantitative polymerase chain reaction panel and demonstrated varying influence of maternal factors on PE development. An additional subclass of PE placentas was also revealed to form because of chromosomal abnormalities in these samples, supported by array-based comparative genomic hybridization analysis. Overall, our findings represent a new paradigm in our understanding of the origins and maternal-placental contributions to the pathology of PE. The study of PE represents a unique opportunity to access human tissue associated with a complex hypertensive disorder, and our novel approach could be applied to other hypertensive and heterogeneous human diseases.

Relationship between ABO blood group and pregnancy complications: a systematic literature analysis

Given the expression of ABO blood group antigens on the surface of a wide range of human cells and tissues, the putative interplay of the ABO system in human biology outside the area of transfusion and transplantation medicine constitutes an intriguing byway of research. Thanks to evidence accumulated over more than 50 years, the involvement of the ABO system in the pathogenesis of several human diseases, including cardiovascular, infectious and neoplastic disorders, is now acknowledged. However, there is controversial information on the potential association between ABO blood type and adverse pregnancy outcomes, including pre-eclampsia and related disorders (eclampsia, HELLP syndrome and intrauterine growth restriction), venous thromboembolism, post-partum haemorrhage and gestational diabetes. To elucidate the role of ABO antigens in pregnancy-related complications, we performed a systematic review of the literature published in the past 50 years. A meta-analytical approach was also applied to the existing literature on the association between ABO status and pre-eclampsia. The results of this systematic review are presented and critically discussed, along with the possible pathogenic implications.

The association of maternal ABO blood group with gestational diabetes mellitus in Japanese pregnant women

AIMS

To investigated the association between the ABO blood group and gestational diabetes mellitus (GDM).

MATERIALS AND METHODS

A retrospective case-control study was conducted using data from 5424 Japanese pregnancies. GDM screening was performed in the first trimester using a casual blood glucose test and in the second trimester using a 50-g glucose challenge test. If the screening was positive, a 75-g oral glucose tolerance test was performed for a GDM diagnosis, which was defined according to the International Association of Diabetes and Pregnancy Study Groups. Logistic regression was used to obtain the odds ratio (OR) and 95% confidence interval (CI) adjusted for traditional risk factors.

RESULTS

Women with the A blood group (adjusted OR: 0.34, 95% CI: 0.19-0.63), B (adjusted OR: 0.35, 95% CI: 0.18-0.68), or O (adjusted OR: 0.39, 95% CI: 0.21-0.74) were at decreased risk of GDM compared with those with group AB. Women with the AB group were associated with increased risk of GDM as compared with those with A, B, or O (adjusted OR: 2.73, 95% CI: 1.64-4.57).

CONCLUSION

ABO blood groups are associated with GDM, and group AB was a risk factor for GDM in Japanese population.

Blood group AB is protective factor for gestational diabetes mellitus: a prospective population-based study in Tianjin, China

BACKGROUND

The ABO blood types are associated with cancers, cardiovascular diseases and type 2 diabetes mellitus but whether they are also associated with gestational diabetes mellitus (GDM) is unknown. We examined the relationship between the ABO blood types and the risk of GDM in a prospective population-based Chinese cohort.

METHODS

From 2010 to 2012, we recruited 14,198 pregnant women within the first 12 weeks of gestation in Tianjin, China. All women had a glucose challenge test (GCT) at 24-28 gestational weeks, followed by a 75-g 2-h oral glucose tolerance test if the results from GCT were ≥7.8 mmol/L. GDM was diagnosed based on the glucose cut-points of the International Association of Diabetes and Pregnancy Study Group criteria. Logistic regression was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) adjusted for traditional risk factors. Stratified analysis was performed by family history of diabetes (yes versus no). Sensitivity analyses were also performed by using the World Health Organization (WHO) criteria for GDM.

RESULTS

Women with blood groups A, B or O (i.e. non-AB) were associated with increased risk of GDM as compared with those with blood group AB (adjusted OR: 1.44, 95% CI: 1.13-1.83). Sensitivity analyses showed that the result was consistent using WHO criteria. The adjusted OR of blood group non-AB versus AB for GDM was enhanced among women with a family history of diabetes (2.69, 1.21-5.96) and attenuated among those without (1.33, 1.03-1.71).

CONCLUSIONS

Blood group AB was a protective factor against GDM in pregnant Chinese women.