Correlation of ABO blood groups with treatment response and efficacy in infants with persistent pulmonary hypertension of the newborn treated with inhaled nitric oxide

Yi Guan; Ya Jin; Yongxue Lu; Dang Ao; Pingjiao Gu; Jiyan Yang; Guosheng Liu; Shasha Han

doi:10.1186/s12884-023-05558-w

Correlation of ABO blood groups with treatment response and efficacy in infants with persistent pulmonary hypertension of the newborn treated with inhaled nitric oxide

BMC Pregnancy Childbirth. 2023 Apr 22;23(1):276. doi: 10.1186/s12884-023-05558-w.

Authors

Yi Guan^#¹, Ya Jin^#¹, Yongxue Lu², Dang Ao³, Pingjiao Gu⁴, Jiyan Yang⁵, Guosheng Liu⁶, Shasha Han⁷

Affiliations

¹ Department of Pediatrics and Neonatology, Institute of Fetal-Preterm Labor Medicine, The First Affiliated Hospital of Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China.
² The First People's Hospital of Foshan, Foshan, 528010, China.
³ Department of Neonatology, the Affiliated Hospital of Guangdong Medical University, Zhanjiang, 524001, China.
⁴ Neonatology Department of Foshan Women and Children Hospital, Foshan, 528099, China.
⁵ Neonatology Department, Guangdong Women and Children Hospital, Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou, 511442, China.
⁶ Department of Pediatrics and Neonatology, Institute of Fetal-Preterm Labor Medicine, The First Affiliated Hospital of Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China. tlgs@jnu.edu.cn.
⁷ Department of Pediatrics and Neonatology, Institute of Fetal-Preterm Labor Medicine, The First Affiliated Hospital of Jinan University, No.601 Huangpu Road West, Guangzhou, 510630, China. hanssha888@163.com.

^# Contributed equally.

Abstract

Objective: Not all infants with persistent pulmonary hypertension of the newborn (PPHN) respond to inhaled nitric oxide (iNO) therapy, as it is known to improve oxygenation in only 50% to 60% of cases. In this study, we investigated whether ABO blood groups were a relevant factor affecting the improvement of oxygenation by nitric oxide (NO) therapy in infants with PPHN.

Methods: This study was a retrospective, multicenter, and cohort-controlled trial that involved 37 medical units. Infants with PPHN who met the inclusion criteria and were treated with NO (a vasodilator) alone from July 1, 2015, to June 30, 2020, were selected and assigned into three groups: blood type A, blood type B, and blood type O (there were only 7 cases of blood type AB, with a small number of cases, and therefore, blood type AB was excluded for further analysis). The response to iNO therapy was defined as an increase in the ratio of the partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) > 20% from the basal value after treatment. Oxygenation was assessed mainly based on the two values, oxygenation index (OI) and PaO2/FiO2. The correlation of ABO blood groups with responses to iNO therapy and their influence on the efficacy of iNO therapy was analyzed based on the collected data.

Results: The highest proportion of infants with PPHN who eventually responded to iNO therapy was infants with blood type O. Infants with blood type O more readily responded to iNO therapy than infants with blood type B. Oxygenation after iNO treatment group was optimal in the blood type O group and was the worst in the blood type A group among the three groups. Infants with blood type O showed better efficacy than those with blood types A and B.

Conclusion: ABO blood groups are correlated with responses to iNO therapy in infants with PPHN, and different blood groups also affect the efficacy of NO therapy in infants with PPHN. Specifically, infants with blood type O have a better response and experience the best efficacy to iNO therapy.

Keywords: ABO blood groups; Efficacy; Inhaled nitric oxide; Persistent pulmonary hypertension of the newborn; Response.

Publication types

Multicenter Study

MeSH terms

ABO Blood-Group System
Humans
Hypertension, Pulmonary*
Infant
Infant, Newborn
Nitric Oxide / therapeutic use
Oxygen
Persistent Fetal Circulation Syndrome* / drug therapy
Retrospective Studies

Substances

Nitric Oxide
ABO Blood-Group System
Oxygen