Related Experiment Video
Updated: Oct 11, 2025
Fetal Echocardiography and Pulsed-wave Doppler Ultrasound in a Rabbit Model of Intrauterine Growth Restriction
Published on: June 29, 2013
Aberrant Hematopoiesis and Morbidity in Extremely Preterm Infants With Intrauterine Growth Restriction
Nora J Reibel1, Christof Dame1, Christoph Bührer1
1Department of Neonatology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Insights
Infants born with intrauterine growth restriction (IUGR) and extremely low gestational age (ELGANs) experience significant hematological disturbances and higher rates of infection and severe pulmonary complications, including death.
Area of Science:
- Neonatology
- Pediatric Hematology
- Perinatology
Background:
- Intrauterine growth restriction (IUGR) presents unique challenges for extremely low gestational age newborns (ELGANs).
- Understanding the impact of IUGR on neonatal hematopoiesis and associated morbidities is critical for improving outcomes.
- Hematological profiles and clinical outcomes in IUGR-ELGANs require further investigation.
Purpose of the Study:
- To assess the disturbed hematopoiesis in IUGR-ELGANs.
- To evaluate the major morbidities and mortality associated with IUGR in ELGANs.
- To compare hematological profiles and clinical outcomes between IUGR-ELGANs and non-IUGR ELGANs.
Main Methods:
- A single-center retrospective case-control study.
- Comparison of 49 IUGR-ELGANs (gestational age <28 weeks, birth weight ≤ 3rd percentile) with 98 matched non-IUGR ELGANs (birth weight >10th percentile).
- Analysis of perinatal hematological profiles, blood product transfusions, antibiotic use, morbidities, and mortality.
Main Results:
- IUGR-ELGANs exhibited elevated nucleated red blood cells and reduced neutrophil and platelet counts.
- IUGR-ELGANs required more transfusions (red blood cells, platelets, plasma) and intensive antibiotic treatment.
- Significantly higher rates of early-onset infections, severe bronchopulmonary dysplasia or death, and overall mortality were observed in IUGR-ELGANs.
Conclusions:
- IUGR-ELGANs demonstrate significant hematological abnormalities and a heightened risk of early-life infections.
- Severe pulmonary morbidity, including bronchopulmonary dysplasia and mortality, is markedly increased in IUGR-ELGANs.
- The high incidence of transfusions in IUGR-ELGANs necessitates further research and clinical scrutiny.
Abstract:
Background and Objective: Intrauterine growth restriction (IUGR) poses additional challenges in extremely low gestational age newborns (ELGANs). We assessed disturbed hematopoiesis and morbidities associated with this disorder. Methods: This single-center retrospective case-control study compared perinatal hematological profiles, major morbidities, and mortality of 49 infants (gestational age <28 weeks, birth weight ≤ 3rd percentile, and compromised placental function) and 98 infants (birth weight >10th percentile) matched for gestational age, year, and sex. Results: IUGR-ELGANs had significantly elevated nucleated red blood cells and lower neutrophil and platelet counts at birth and on the third day of life. During the first week of life, IUGR-ELGANs received more red blood cell, platelet, and plasma transfusions and were more intensively treated with antibiotics. Rates of infections acquired during the first week (59.2 vs. 17.3%, p < 0.001), severe bronchopulmonary dysplasia or death (42.9 vs. 17.3%, p < 0.01), and mortality (36.7 vs. 7.1%, p < 0.001) were markedly elevated in IUGR-ELGANs, but not of hemorrhages or other morbidities. Conclusions: IUGR-ELGANs have high rates of acquired infections during the first week of life and display severe pulmonary morbidity leading to bronchopulmonary dysplasia or death. The high rate of transfusions observed in these infants warrants further scrutiny.
Related Concept Videos
01:28Role of Hematopoietic Growth Factors
Thrombopoietin (TPO), mainly released by the liver,...
01:20Overview of Hematopoiesis
Developmental Phases of Hematopoiesis
Initially, HSCs are formed in the embryonic yolk sac, a critical site for early blood cell production. These stem cells subsequently migrate to other...
01:27Disorders of Erythrocytes
Erythrocyte disorders can be broadly categorized into two main types: anemic and polycythemic conditions.
A low oxygen-carrying capacity of the blood due to the loss, lower production, or destruction of erythrocytes is termed anemia. Hemorrhagic anemia, for example, occurs when bleeding from an external wound or internal ulcer reduces erythrocyte counts.
On the other...
01:01Regulation of Hematopoietic Stem Cells
01:22Bone Marrow Sampling and Transplants
The transplant begins with high doses of chemotherapy and radiation treatment, which aim to destroy...
01:07Teratogenicity