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Postnatal fetal and adult hemoglobin synthesis in early preterm newborn infants

H Bard

    The Journal of Clinical Investigation
    |August 1, 1973
    PubMed

    Insights

    Preterm infants show a similar transition from fetal hemoglobin (Hb F) to adult hemoglobin (Hb A) synthesis as observed in utero. Postnatal development of Hb A and Hb F levels in preterm infants matches term infants by their due date.

    Area of Science:

    • Neonatal physiology
    • Hematology
    • Biochemistry

    Background:

    • Fetal hemoglobin (Hb F) is the primary oxygen-carrying molecule in fetuses, gradually replaced by adult hemoglobin (Hb A) after birth.
    • Understanding the transition from Hb F to Hb A synthesis is crucial for assessing infant development, especially in preterm infants.

    Purpose of the Study:

    • To investigate the rate of fetal hemoglobin (Hb F) and adult hemoglobin (Hb A) synthesis in preterm infants during the postnatal period.
    • To compare Hb F and Hb A synthesis in preterm infants with term infants at equivalent postconceptional ages.

    Main Methods:

    • Blood samples from preterm and full-term infants were analyzed using radiolabeled amino acid incorporation and DEAE-Sephadex column chromatography.
    • Hemoglobin fractions (Hb F and Hb A) were separated and quantified.
    • Globin chain chromatography confirmed the accuracy of Hb F and Hb A separation.

    Main Results:

    • The postnatal transition of Hb F to Hb A synthesis in preterm infants mirrored the in utero transition process.
    • By the postconceptional age equivalent to term, preterm infants exhibited similar relative amounts of Hb F and Hb A synthesis as term infants.
    • The process of birth did not significantly impact the rate of transition from Hb F to Hb A synthesis.

    Conclusions:

    • Preterm infants' hemoglobin synthesis follows a developmental trajectory similar to that of in utero development.
    • The transition from fetal to adult hemoglobin is a continuous process not significantly altered by birth in preterm infants.
    • These findings support the understanding of normal hematological maturation in infants born prematurely.

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