Interaction between ABO blood groups and ADA genetic polymorphism during intrauterine life

A total of 203 couples with unexplained habitual abortions and 364 consecutive normal puerperae along with their live-born babies were studied. The analysis of wife-husband joint ABO blood group distribution in couples with habitual abortion showed an excess of A incompatible mating type and a defect of B incompatible type as compared with expected proportions assuming random mating. The joint wife-husband ABO blood group distribution was further analysed in relation to the adenosine deaminase (ADA) genotype. A defect of O-A and A-O couples when the wife carries the ADA*1/*1 genotype and the husband carries the ADA*2 allele, and a defect of O-O and A-A when the wife carries the ADA*2 allele were observed. In the sample of normal puerperae, analysis of the joint mother-newborn ABO distribution in relation to the ADA genotype showed a pattern similar to that observed in couples with habitual abortion, i.e. there is a defect of O-A and A-O when the mother carries the ADA*1/*1 genotype and the newborn carries the ADA*2 allele and a defect of O-O and A-A types when the mother carries the ADA*2 allele. Altogether the data suggest an early loss of O-A and A-O zygotes when they carry the ADA*2 allele and an early loss of O-O and A-A zygotes when the mother carries the ADA*2 allele resulting in a deficit of these zygotic classes among both spontaneously aborted fetuses and live-born infants. The pattern of association observed in the mother-fetus type O-A (incompatible according to conventional terminology) appears similar to that observed for the reciprocal A-O type (compatible according to conventional terminolgy). Therefore strictly conventional immunological mechanisms cannot explain the whole pattern of associations. Cell to cell interactions involving ABO antigens may have an important role at implantation: ADA, through the control of local adenosine concentration, could modulate these interactions influencing the probability of successful implantation.     

Abo blood groups and completed reproductive performance of rural Haryanavi couples: analysing measures of selection intensities

The possible differential effects of ABO blood group materno-paternal (fetal) incompatibility on completed reproductive performance were investigated on a sample of 100 couples (100 fathers and 100 mothers) from three villages in the Jind district of Haryana state, India. The average number of live births per mating couple was slightly higher for the incompatible matings (5.32) than the compatible ones (5.05). This advantage was offset by higher postnatal mortality in the former. Consequently, the average number of living children in the compatible matings (4.64) was higher than in the incompatible ones (4.18). With reference to individual ABO matings, the index of relative fertility (Irf) was the highest in A x AB followed by B x A type of incompatible matings. No decrease in live births in O x A and O x B incompatible matings was observed compared with their reciprocal compatible ones, i.e. A x O and B x O matings, as has been hypothesized in previous studies. The total pregnancy wastage was substantially higher in ABO-incompatible matings (24.59%) than compatible matings (8.45%). About 71% of the postnatal deaths took place within one year of the birth in the case of incompatible matings compared with 50% in the case of compatible matings. The study supports the hypothesis that selection is operative at the ABO locus as revealed by the measures of selection intensity. The loss of fitness in the present sample was associated with differential mortality. There were no differences in the proportions of average number of male live births in the compatible (0.55) and incompatible matings (0.58). However, in the individual mating types, there was some evidence of higher or lower proportions of male live births.     

Incidence of Maternal Rh Immunization by ABO Compatible and Incompatible Pregnancies

The incidence of maternal Rh immunization in Rh-negative women following a single ABO compatible Rh-positive pregnancy is about 17%. This incidence was determined by following Rh-negative women through two Rh-incompatible pregnancies and analysing their sera for anti-Rh at the time of delivery of their second observed pregnancy. Maternal Rh immunization occurs almost exclusively after delivery; however, antibodies may not be detectable in the absence of further antigenic stimulation.The incidence of maternal Rh immunization when maternal-foetal ABO incompatibility is also present is 9–13% and 17% for group O and non-group O women respectively. This study emphasizes the need to offer Rh-immune prophylaxis to Rh-negative women having Rh-positive infants whether or not ABO incompatibility exists between the mother and infant.     

ABO incompatibility and reproductive failure. I. Prenatal selection

An analysis of previous spontaneous abortions and the frequencies of blood-group combinations in mother-child pairs was carried out in 500 gravidae. The rate of previous spontaneous abortions in blood-group-O women whose latest child has blood group B is significantly higher than in all other women. On the other hand, the combination mother B/child AB is rarer than expected, but no increase in the rate of previous spontaneous abortions is obvious among these women. These discrepancies are interpreted as an indication that prenatal selection associated with ABO incompatibility may operate at various stages from fertilization through pregnancy, and that different incompatible combinations may be subject to selection at different stages.     

Frequencies of ABO, Rh and Kell phenotypes in couples from Han, Kazak, Uyghur and Hui in Xinjiang: an inheritance simulation model for blood group incompatibility in new-born

The Xinjiang region with residents from more than 13 minorities represents an area of many diverse ethnicities. This ethnic diversity in relation to their blood groups and immune status may have a consequential impact on the clinical status of married couples. To evaluate the risks of haemolytic disease in new-born infants, we investigated the rate of blood-group incompatibility among 487 married couples from four ethnic minorities, namely the Han, Hui, Uyghur and Kazak populations. Han minority married couples showed significantly different ABO, Rh and K phenotype frequencies between marrial relationship, whereas there was no significant difference in ABO, Rh and K phenotypes between the Uyghur, Hui and Kazak .There was a significant difference between ABO blood types in Han married couples, in the Kazak Rh-C phenotype and in the Uyghur Rh-D phenotype. The Hui married couples only demonstrated ABO, Rh and K phenotypes. The Hui minority showed the highest incompatibility rate for Rh-C and Rh-E phenotypes between mothers and their new-born infants. The highest incompatibility rate for the ABO phenotype occurred in the Kazak group. These results particularly demonstrate the clinical issues relating to ABO and Rh incompatibility, in the Kazak and Hui minorities, respectively.     

ABO blood groups and fertility—with special reference to intrauterine selection due to materno-fetal incompatibility

The purpose of the present investigation was to study whether there is differential fertility between different mating types of ABO blood group system. Selective force which is operating through maternal-fetal incompatibility has been observed in the differential fertility between compatible and incompatible mating groups in the present sample of 183 families of Visakhapatnam town of Andhra Pradesh, India. The differences in the mean numbers of pregnancies as well as living children between the two major mating groups, compatible and incompatible are significant. The fertility rates of O fathers and O mothers were significantly higher than those in matings in which neither parents belongs to O. The selection is operating to reduce the gene ratio of A and to increase the gene ratios of O and B in this sample.     

Increased activating killer immunoglobulin-like receptor genes and decreased specific HLA-C alleles in couples with recurrent spontaneous abortion

Accumulating evidence indicates natural killer (NK) cells play crucial roles in successful pregnancy. To investigate whether the killer cell immunoglobulin-like receptor (KIR) gene polymorphism and the corresponding specific HLA ligands in parent couples possessing a susceptibility to unexplained recurrent spontaneous abortion (RSA), we searched 73 pairs of childless couples with three or more abortions characterized as unexplained RSA and 68 pairs of healthy control couples. Peripheral blood was drawn to obtain genomic DNA which was used for a polymerase chain reaction using sequence-specific primers (PCR-SSP) in order to determine whether 15 selected KIR genes and two groups of HLA-C alleles were present. Our result showed that gene frequency of KIR2DS1 was higher in patients with RSA compared to that of control subjects (P =0.029). Increased numbers of activating KIR genes was observed in patients (P =0.041). Women who possessed more than two activating KIR genes were found more frequently in patients than those in control subjects (P =0.018). From a cohort of husband and wife couples, the women with a KIR2DS1 gene, and with a decreased group 2 HLA-C allele for the homologous inhibitory receptor KIR2DL1, had a tendency to fall into the RSA group (P =0.004). The results suggest that a genetic variation at the KIR locus influences the susceptibility to unexplained RSA in the Chinese Han population. Moreover, decreased ligands for inhibitory KIRs could potentially lower the threshold for NK cell activation, mediated through activating receptors, thereby contributing to pathogenesis of RSA.     

Selective interactions among Rh,ABO, and sex ratio of newborns

Summary The hypothesis that the Rh and ABO blood systems behave like the HLA system in relation to mother-conception tolerance-rejection mechanisms was tested in 25,501 mother-infant pairs. According to this hypothesis, heterozygotes carrying a paternal gene that is not present in their mother should be better tolerated than homozygotes. Significantly more BO infants born to AO mothers. AO infants born to BO mothers, Rh(+) heterozygotes born to Rh(-) mothers, and less significantly AO infants born to OO mothers confirm the hypothesis. Fewer homozygotes occurred in Rh(-) infants born to Rh(+) mothers and in O infants born to non-O mothers. Deviations from the Hardy-Weinberg equilibrium found in the ABO system were modified by the Rh and sex of the infant. These data strongly support the hypothesis that at least two feto-maternal systems influence the denstiny of pregnancies: the classical known incompatibility system which operates late in pregnancy and a new one which is based on the induction of maternal tolerance early in pregnancy: maternal tolerance seems to be better elicited by heterozygous eggs or embryos carrying a gene not present in the mother. The data also support the hypothesis that the sex ratio is influenced by feto-maternal tolerance-rejection mechanisms associated with the ABO and Rh systems.     

Acuity of selective mechanisms operating on ABO, Rh, and MN blood groups

Selection in ABO, Rh, and MN blood groups was studied in 216 matings and their children in an endogamous population. Incompatibility status with respect to these three systems was considered simultaneously. There is no effect of incompatibility on number of pregnancies. Analysis of variance between groups confirms that prenatal loss is associated with incompatibility, and it is greater when the matings are incompatible for any two systems. There is no significant intergenerational change in ABO and Rh polymorphisms. Segregation analysis for the ABO system suggests that there is no significant difference in the proportion of A, B, and O children, based on the compatibility of the parents, while analysis for Rh-D system showed a segregation distortion which is not related to the known antigenic specificities (mother-child incompatibility).     

Haptoglobin-ABO interaction: a possible explanation for the excess of Hp 1 among offspring of ABO incompatible matings.

The Hp1 frequency among ABO phenotypes varies in the Hutterite population as follows: O less than A less than B less than AB. Within group O, the Hp1 frequency is significantly lower than the Hp1 frequency among the other groups combined. The Hp1 frequencies among ABO genotypes, known by means of family pedigrees, vary as follows: OO less than AO less than BO less than AB less than AA less than BB. This holds for both main subjects of this isolate, although they have been reproductively isolated since World War I. The higher Hp1 frequency among type A, B, and AB individuals explains the observation of the higher Hp1 frequencies found among H-leut offspring who are incompatible with their mothers (mainly AO offspring of OO mothers) compared to offspring from the same matings who are compatible with their mothers.     

Effect of ABO Incompatibility on Pregnancy-Induced Rh Isoimmunization

The protective effect of ABO incompatibility between mother and fetus in respect of pregnancy-induced Rh isoimmunization has been recognized for approximately 20 years. Many have tacitly assumed that this protection was absolute and that when an infant was born with Rh hemolytic disease of the newborn, who was also ABO-incompatible with its mother, there must have been a previous ABO-compatible pregnancy in which the mother was initially sensitized. It has also been assumed that pregnancy-induced Rh isoimmunization could not occur if the father was AB and the mother O. Data are presented to show that both of these assumptions are not universally true. In a detailed study of a large number of families with pregnancy-induced Rh iso-immunization, nine families were found in which sensitization occurred and in which ABO incompatibility was present in every pregnancy. In addition, three families are documented in which pregnancy-induced Rh immunization had occurred and in which the father was AB and the mother O.     

The birth of a lowland gorilla in captivity

A 7 year-old captive-born mother-reared gorilla gave birth to a healthy infant after being in labor for 27 min. The young female was a wholly competent mother although she had never observed gorilla mothers or interacted with gorilla infants. This reinforces previous evidence, still often ignored by zoo officials, that gorillas do not have to learn maternal behavior.     

Distribution of blood antigens A, B, and D, in the population of Bogotá (Analysis of 30,000 samples)

As tested by anti-A and anti-B sera, blood drawn from 30,000 inhabitans of Bogotá, Colombia, showed the following phenotype percentages: A — 26.5, B — 8.0, AB — 1.1, and O — 64.4. The allele frequencies were: A — 0.150, B — 0.048, and O — 0.802. In the same samples anti-D (Rh₀) was used: 94.6% of the individuals carried the D antigen. All bloods were typed with fresh commercial sera. No back-typing was performed. Hemolytic disease of the newborn, caused by Rh-Hr isoimmunization, is more frequent (0.40%) in Bogotá than should be expected for a population having only (5.4%) or less “Rh negative” individuals. This paradoxical fact was observed in the analysis of 12,672 deliveries in an obstetrical hospital of Bogotá. A possible explanation could be the multiparity of Colombian women since the possibility of isoimmunization and hemolytic disease increases with each succeeding pregnancy in a given woman. Also it is well established that when Rh-Hr incompatibility is combined with ABO incompatibility, it is less apt to produce disease than when it occurs alone. AO isoimmunization should therefore be less frequent in Bogotá than in populations that have a higher frequency of A individuals. Thus, the women of Bogotá are less “protected” from Rh-Hr immunization by ABO incompatibility.     

ABO Incompatibility and parity effects on perinatal mortality

Abstract

The perinatal mortality rate is known to increase with parity. This parity effect is shown to be steepest for “O"‐type mothers, compared to mothers with blood groups A, B, or AB. Thus, there is a heightened parity effect in mothers who are likeliest to be antigenically dissimilar from their fetuses. This model may also be germane to other clinical conditions where negative parity effects are observed. Maternal‐fetal immunoreactivity is a likely explanation for parity effects on perinatal mortality attributable to ABO incompatibility and may also contribute to the occurrence of negative parity effects in other conditions.     

ABO hemolytic disease of the newborn as a selection mechanism at the ABO locus

Data from the period 1951 to 1967 were collected from the records at the Milwaukee Blood Center on 380 cases of ABO hemolytic disease to determine if ABO incompatibility may be regarded as a selection mechanism at the ABO locus. In comparison with infants of ABO compatible parents the affected infants had significantly lower hemoglobin and hematocrit values and higher bilirubin concentrations. Forty-eight percent of the affected showed a positive direct antiglobulin test, 81% showed increased numbers of reticulocytes and 92% had spherocytosis. Since affected infants are considered to be in grave danger when high concentrations of bilirubin are present it is significant that 169 individuals (44%) required exchange transfusions. Compared with the number of live births in Milwaukee for the same period this represents a frequency of one in every 1,654 live births so that ABO incompatibility may be regarded as an important mechanism of natural selection. Since it was found that 98.7% of the mothers of the affected infants are of blood group O, the affected infants are therefore heterozygous (AO or BO) and selection due to ABO incompatibility would have its greatest effect upon the lowest allele frequencies in a population.     

A unique, predominant hepatitis C virus variant found in an infant born to a mother with multiple variants.

To demonstrate vertical transmission of hepatitis C virus (HCV) from an HCV-infected, non-human immunodeficiency virus type 1-infected mother to her infant and to assess the distribution of viral species in the mother and infant, the hypervariable region of the gene encoding the putative envelope glycoprotein E2 (E2HV) was sequenced in three mothers and one mother-infant pair. The data indicate that (i) quasi-species distributions of HCV E2HV variants were found in all four mothers, (ii) a single predominant HCV E2HV variant was found in the infant of a mother shown to have nine predominant E2HV variants, and (iii) the infant's E2HV variant was highly related to, but not identical with, the nine variants identified in the mother at the time of birth. These findings indicate that HCV is transmitted from mother to infant and raise the possibility that the transmission occurs in utero.     

新生儿ABO 溶血病相关危险因素的临床分析

目的:分析新生儿ABO溶血病的临床相关危险因素,提高对新生儿ABO溶血病的防治水平。方法:选择ABO血型不合的孕妇433例,根据以上产妇产前IgG抗A(B)效价、产妇妊娠次数和产妇年龄分别分组,分析各组产妇间发生新生儿溶血病(HDN)的差异及临床相关性。结果:产妇产前IgG抗A(B)效价、产妇妊娠次数和产妇年龄均与HDN发生率呈正相关性(P<0.05);IgG抗A(B)效价>256时,HDN发生率将显著提高(P<0.01);产妇妊娠次数和年龄增加后,HDN发生率将显著增加(P<0.01)。结论:夫妻血型不合的产妇进行产前保健时,应进行IgG抗A(B)效价检查,当IgG抗A(B)效价>64或IgG抗A(B)效价进行性增加时,应及早做好HDN的干预措施;通过减少意外妊娠及高龄产妇数量,可减少HDN的发生。     

Effects of motherhood on physiological and subjective responses to infant cries in teenage mothers: a comparison with non-mothers and adult mothers

The present study was designed to determine whether becoming a mother during the adolescent period changes maternal responsiveness or maternal motivation, assessed through hormonal, autonomic, and hedonic responses to recorded infant cries and interactions with their babies. Fifty-six teen mothers were compared to 58 teen non-mothers and 49 adult mothers. Teen mothers reported more sympathy and alertness in response to recorded infant cries compared to non -mother teens; however, among the teen women there were no differences between mothers and non-mothers in heart rate and cortisol responses to infant cries. In contrast, in comparison to adult mothers, teen mothers reported the same levels of sympathy and alertness to infant cries; however, adult mothers showed an 'alerted' pattern of heart rate and cortisol response to infant cries not seen in the teen mother group. Inclusion of the covariate, fathers' employment classification as an index of SES or time of testing and cortisol sampling did not affect this pattern of results. Taken together, these results show that where self-report is used as a measure of maternal responsiveness, teen mothers are no different in responsiveness than adult mothers; however, where physiological and interactional measures of responsiveness are considered, teen mothers are less likely to show heightened or selective responses to infant cries or respond 'attentively' to the infant.     

Severe hypothyroidism caused by hepatic hemangioendothelioma in an infant of a diabetic mother

Hemangioendotheliomas can express type 3 iodothyronine deiodinase and cause severe hypothyroidism. The risk of congenital malformations such as vertebral and cardiac abnormalities in infants of diabetic mothers is higher than in babies of healthy women. Here we report an infant of a diabetic mother with hypothyroidism caused by liver hemangioendothelioma. Consumptive hypothyroidism should be an indicator to search for a vascular tumor in infants. Supranormal doses of L-thyroxine might be required for normalization of thyroid function until the tumor involutes or is resected.     

ABO blood groups and fertility in an Indian population

A total of 589 compatible mating couples could be investigated against 432 incompatible mating couples in order to determine the selective mechanism operating on ABO blood groups. There appears to be no striking difference in the proportion of childless couples between the two groups. The mean number of living children presents a significant difference. There is 21% deficiency of 'A' children in the two groups. Similarly, there is 16% deficiency of 'B' children in the two groups. It appears that there is 31.9% fetal wastage in incompatible matings as compared with 17.15% in compatible matings.