Pregnancy · Blood Type
Blood Type & Inheritance in Pregnancy
ABO + Rh blood type basics, what each parent passes, what Rh-negative means in pregnancy (anti-D pathway from 28 weeks), ABO incompatibility and newborn jaundice. NICE NG201.
Last reviewed June 2, 2026
What blood type will my baby have?
Mother's blood type
ABO group
Rh factor
Father's blood type
ABO group
Rh factor
Two blood type systems matter in pregnancy
- ABO (A, B, AB, O): minor incompatibility can cause mild newborn jaundice.
- Rh (positive / negative): if mum Rh-neg and baby Rh-pos, mum can develop antibodies that attack baby’s blood cells in future pregnancies.
Rh-negative pregnancy
- Booking blood test identifies Rh status.
- Antibody screen at booking + 28 weeks.
- Anti-D injection at 28 weeks (and after delivery if baby Rh-pos).
- Some UK trusts: cffDNA at 11-13 wk determines baby’s Rh from mum’s blood.
- Anti-D after any sensitising event (bleeding, trauma, miscarriage, amnio).
See /calculators/anti-d-dosing for full detail.
ABO incompatibility
When mum is O and baby is A or B. Mum’s natural anti-A or anti-B antibodies cross placenta. Usually MILDER than Rh disease.
Presentation: neonatal jaundice in first 24 hours; sometimes anaemia. Treatment: phototherapy usually sufficient; rarely exchange transfusion.
No antenatal prophylaxis for ABO; managed reactively.
Inheritance basics
- O × O → O only.
- A × A → A or O.
- B × B → B or O.
- O × A → O or A.
- AB × anything → many possibilities.
- Both Rh-neg → baby Rh-neg.
- Either Rh-pos → baby could be Rh-pos.
Other antibodies that matter
Besides anti-D: anti-c, anti-Kell, anti-Duffy, anti-Kidd, anti-MNS.
Rare but serious. Antibody screen at booking + 28 wk detects.
Anti-Kell particularly aggressive — severe anaemia at lower titers than anti-D.
Ethnicity
- Caucasian: ~15% Rh-neg.
- Black: ~5-8%.
- East Asian: <1%.
- Basque: ~25% — highest.
- South Asian: ~5%.
Different scenarios
Scenario 1: O-negative mum, O-positive partner
Baby likely Rh-pos. Anti-D pathway. Consider cffDNA at 11-13 wk to confirm.
Scenario 2: O mum, AB baby (after birth)
ABO incompatibility possible. Watch for early jaundice; phototherapy if needed.
Scenario 3: Anti-Kell antibodies found at booking
Specialist fetal medicine. Monitoring MCA Doppler for fetal anaemia. Possible intrauterine transfusion.
Scenario 4: Rh-neg, partner also Rh-neg
Baby Rh-neg. No anti-D needed. Anti-D pathway not relevant.
Scenario 5: cffDNA at 12 weeks shows baby Rh-negative
No anti-D this pregnancy. Saves unnecessary injections.
Care guidance — blood type
- Booking blood tests establish type.
- Rh-neg: anti-D pathway essential.
- cffDNA option at 11-13 wk where available.
- Antibody screen booking + 28 wk.
- Partner’s type helpful but not essential.
- ABO usually self-resolves with phototherapy if needed.
- O-type mums: watch for early newborn jaundice.
- Rare antibodies: specialist fetal medicine care.
Sources
- NICE NG201. Antenatal care.
- RCOG Green-top Guideline 22. Anti-D immunoglobulin.
- NHS Blood and Transplant. nhsbt.nhs.uk.
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