Hemolytic Disease of the Newborn

What is hemolytic disease of the newborn?

Hemolytic disease of the newborn (HDN) — also called erythroblastosis fetalis — is a blood disorder that occurs when the blood types of a mother and baby are incompatible. HDN is relatively uncommon in the United States due to advances in early detection and treatment, limiting it to approximately 4,000 cases a year. It is more likely to happen during a mother’s second or subsequent pregnancy. There are two causes, Rh incompatibility and ABO incompatibility. HDN due to Rh incompatibility occurs more frequently and is often called Rh disease; it is about three times more likely in Caucasian babies than in African-American babies. HDN can be treated during pregnancy or after the baby is born.

Hemolytic disease of the newborn is very preventable. Today, nearly all women with Rh-negative blood are identified in early pregnancy through blood tests. If a mother is Rh-negative and has not been sensitized, she is usually given a drug called Rh immunoglobulin, or RhoGAM. This specially developed blood product prevents an Rh-negative mother's antibodies from reacting to her baby’s Rh-positive red blood cells. Mothers are typically given RhoGAM around the 28th week of pregnancy and again within 72 hours of giving birth.

How we care for HDN

Hemolytic disease of the newborn (HDN) is treated through the Blood Disorders Center at Dana-Farber/Boston Children's. Hemolytic disease of the newborn was first identified in 1932 at Boston Children’s Hospital by Dr. Louis Diamond. He went on to develop the first successful treatment, a transfusion procedure, in the 1940s.