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Twelve infants with neonatal hyperbilirubinemia caused by Rh or ABO incompatibility were followed for 1 year after birth. Antibodv determinations for diphtheria, tetanus, pertussis and three strains of E. coil (026, 055, and 079) were done. The results were compared with those from a control group of 25 healthy infants and from 40 infants who had received exchange transfusion after birth. The data suggests that bilirubin is a causative factor in the significant depression of antibody levels against diphtheria, tetanus, and pertussis in infants with hyperbilirubinemia when compared to healthy infants. [see pdf for figures]

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Dr. Nejedlá comments as follows: I agree with Dr. R. H. Rapkin's opinion that it would be necessary to examine a further group of neonates with hyperbilirubinemia without incompatibility to prove completely the influence of bilirubin on the development of immunologic reactivity. At present we have such a group under observation. Only one child of the 12 mentioned in our study, did not show any incompatibility. However, I cannot agree with the explanation of Dr. Rapkin that maternal placentally transferred antibodies suppress the antibody formation by the infants still at the age of 6 months.