The Diagnostic Potential of the L Score for ABO Hemolytic Disease of the Newborn: Insights from a Cross-Sectional Study.

PURPOSE: This study aimed to evaluate the diagnostic efficacy of the L score, a novel scoring system, in distinguishing between ABO hemolytic disease of the newborn (ABO-HDN) and non-hemolytic disease of newborn hyperbilirubinemia (NHDNH).

METHODS: A cross-sectional prospective study was conducted to assess the effectiveness of the L score in distinguishing between ABO-HDN ( n  = 118) and NHDNH ( n  = 213). Blood routine examination results were collected, and relevant statistical analyses were performed to identify clinically significant parameters. Binary logistic regression analysis was employed to assess the relationship between the L score and the development of these conditions, considering relevant variables.

RESULTS: Our study identified the red blood cell count, mean corpuscular volume, red blood cell distribution width-coefficient of variation, and red blood cell distribution width-standard deviation as independent risk factors for distinguishing ABO-HDN from other high bilirubinemia conditions ( P  < 0.001). The L score demonstrated superior predictive performance for ABO-HDN, exhibiting an area under the curve (AUC) of 0.746, with an optimal cutoff value of - 3.0816. The RBC-L score exhibited superior predictive performance (z: 5.596, P  < 0.0001) compared to the single-factor RBC indicator, indicating its efficacy in accurately identifying the desired outcome.

CONCLUSION: The L score represents a valuable tool for predicting neonatal hyperbilirubinemia and hemolytic disease, facilitating differentiation, and guiding early intervention for improved outcomes. Further research is warranted to validate and expand the applicability of the L score in clinical practice.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12288-023-01723-5.