TY - JOUR T1 - QUESTION 1: Does folic acid supplementation reduce the incidence or severity of anaemia in neonates with a positive direct Coombs test? JF - Archives of Disease in Childhood JO - Arch Dis Child SP - 1071 LP - 1073 DO - 10.1136/archdischild-2016-311508 VL - 101 IS - 11 AU - Benjamin G Fisher AU - Raman Lakshman Y1 - 2016/11/01 UR - http://adc.bmj.com/content/101/11/1071.1.abstract N2 - You are called to review a healthy term neonate on the postnatal ward whose mother's blood group is O Rhesus D (RhD)-negative and whose own blood group (determined from umbilical cord blood) is A RhD-positive. A direct Coombs test is ‘2+ positive’. According to departmental protocol, the neonate should be started on oral folic acid 500 μg daily from discharge until weaning, supposedly to reduce the risk of late haemolytic anaemia. You wonder as to the value of this intervention.In a neonate with a positive direct Coombs test (patient), does folic acid supplementation until weaning (intervention) compared with placebo (control) reduce the incidence or severity of anaemia (outcome)? Secondary sources: None. Primary sources: Medline and Embase were searched using the Ovid interface (1946 and 1974, respectively, to current date) in June 2016. The following keywords were used: (‘Coombs test’ or ‘anti*globulin test’ or allo*immuni*ation or iso*immuni*ation or erythroblastosis or ‘h*emolytic disease’) and (‘folic acid’ or folate) and an*emia. The results were limited to English language and the age groups infant and child. The search retrieved 39 individual articles, of which two were relevant primary sources (summarised in table 1). Further indirect evidence was obtained from a review article retrieved in the search and its references.View this table:In this windowIn a new windowTable 1 Does folic acid supplementation reduce the incidence or severity of anaemia in neonates with a positive direct Coombs test?The direct Coombs (or … ER -