Abstract: Objective To provide guidelines for safe exchange transfusion and subsequent transfusion treatment, we compared three groups of laboratory indexes before and after exchange transfusion, i.e. ABO blood type incompatibility, Rh blood type incompatibility and unexplained neonatal hyperbilirubinemia. Methods Thirty-five cases of newborns undergoing exchange transfusion in our hospital from January 2017 to December 2021 were selected, and the laboratory indexes including hemoglobin and serum total bilirubin were analyzed before and after exchange transfusion. Results Before exchange transfusion, the hemoglobin and serum total bilirubin levels in the Rh blood type incompatibility group were lower than those of the unexplained hyperbilirubinemia group. However, 24 h or 48 h after exchange transfusion, the serum total bilirubin level was higher in the Rh blood type incompatibility group than in the ABO blood type incompatibility group and the unexplained jaundice group.There were significant differences in hemoglobin and serum total bilirubin among different types of neonatal hyperbilirubinemia posttransfusion （P<0.05）. Conclusion The pathogenesis of hyperbilirubinemia and the posttransfusion levels of hemoglobin and total bilirubin seem to vary with different types of neonates with this disease.

Key words: Neonate, Hyperbilirubinemia, Exchange transfusion therapy