Dual-biomarker strategy for prenatal prediction of ABO hemolytic disease: Maternal sVE-cadherin and anti-A/B IgG titer

ABO-haemolytic disease of the fetus and newborn remains the leading cause of neonatal hyperbilirubinaemia; however, a reliable antenatal predictor is currently lacking. This study aimed to investigate whether the combination of maternal soluble vascular-endothelial cadherin (sVE-Cadherin) levels with immunoglobulin γ (IgG) anti-A/B titers enhances prenatal detection of ABO-haemolytic disease of the fetus and newborn. We conducted a case-control study involving blood group O Rh(D)-positive mothers, categorized based on the occurrence of ABO hemolytic disease in their newborns. The maternal sVE-cadherin levels and anti-A/B IgG titers in the 2 groups were compared and analyzed. Additionally, we analyzed their correlation with total bilirubin levels in infants and assessed their diagnostic value for the prenatal detection of ABO hemolytic disease. The sVE-cadherin levels and anti-A/B IgG titers of pregnant women in the ABO hemolytic disease group were significantly higher than those observed in the control group (P < .001). A positive correlation was found between sVE-cadherin levels and total bilirubin (R2 = 0.503, P < .001) in the ABO hemolytic disease cohort. The area under the curve (AUC) for the sVE-cadherin level was 0.844, with a sensitivity of 84.91% and specificity of 70.00%. For the anti-A/B IgG titer, the AUC was 0.897, with a sensitivity of 96.23% and specificity of 72.73%. When combined for diagnosis, these metrics yielded an AUC of 0.923, a sensitivity of 95.24%, and a specificity of 86.84%. Maternal sVE-cadherin levels along with anti-A/B IgG titers provide significant reference values for prenatal diagnosis of ABO hemolytic disease; together, they demonstrate excellent joint diagnostic efficacy.