Which statement about ABO incompatibility is accurate?

The statement highlighting that significant problems occur mostly with mothers of O blood type and babies with A or B blood types is accurate due to the immunological implications associated with the ABO blood group system.

Mothers with type O blood produce anti-A and anti-B antibodies that can cross the placenta and target red blood cells of the fetus if the baby has type A or B blood. This can lead to hemolytic disease of the newborn, where the baby's red blood cells are destroyed more rapidly than usual. This condition can result in jaundice and other complications.

In contrast, other statements regarding the rarity of ABO incompatibility in preterm infants, the increasing severity in subsequent pregnancies, and the notion that incompatibility cannot occur in first-born babies do not accurately reflect the nuances of the ABO blood group incompatibility. While it is true that ABO incompatibility can indeed occur in first-born babies, it is most prevalent in cases involving mothers with type O blood who have infants of type A or B.