The changes of fetal hemoglobin in preterm and small for gestational age newborn infants

Park, Eun Ae; Kim, Gyoung Hee

Abstract

The fetal hemoglobin, which is structurally different from adult hemoglobin, has higher affinity for oxygen and higher resistance to denaturation with alkali than adult hemoglobin. Intrauterine growth retarded neonates have higher mortality and morbidity than normal neonates. In this article, to determine the changes of fetal hemoglobin by gestational age in infants appropriate in weight for gestational age (AGA)and to explain the mechanism underlying the increased fetal hemoglobin synthesis in intrauterine growth retarded newborn infants, the proportion of fetal hemoglobin and adult hemoglobin at birth and 1 month of age was checked in 25term infants small for gestational age(TSGA). The results were compared with 50 preterm infants appropriate in weight for gestational age (paga) and 40 term infants appropriate in weight for gestational age (TAGA). The results were as forllows. 1)The decrease of fetal hemoglobin by gestational age in infants of AGA at birth was statistically significant (p<0.01). 2) The fetal hemoglobin at birth was 74.47+/-2.4%n the TSGA group, 78.01+/-5.05% in the PAGA group and 68.32+/-4.84% in the TAGA group. The differnce between each group was statistically significant (p<0.01). 3) The fetal hemoglobin at one month of age was 55.68+/-3.76% in the TSGA group, 35.74 (13.33%in the PAGA group and 59.96+/-5.53% in the TAGA group. The difference between TSGA and TAGA infants was not significant (p>0.05). 4) The decrese rate of fetal hemoglobin between first day and one month of postantal age was 54.2% in the PAGA infants, 25.2% in the TSGA infants and 12.2% in the TAGA infants. 5) The fetal hemoglobin at forty weeks of postconceptional age was 13.20+/-5.09%in the transfused PAGA group, 62.34+/-3.01% in the nontransfused PAGA group, 64.08+/-2.08% in the TSGA group and 68.32+/-4.12% in the TAGA infants. The difference between transfused PAGA group and other groups was statistically significant (p<0.05).