Related Experiment Videos
Haemoglobin concentrations and erythropoietin levels in appropriate and small for gestational age infants
Insights
Small for gestational age (SGA) infants have higher hemoglobin levels at term compared to appropriate for gestational age (AGA) infants. Erythropoietin levels increase towards term but do not correlate with hemoglobin concentration.
Area of Science:
- Neonatal physiology
- Hematology
Background:
- Hemoglobin (Hb) concentration and erythropoietin (EP) levels are critical during fetal development.
- Understanding factors influencing these parameters in term infants is essential for neonatal care.
Purpose of the Study:
- To compare capillary Hb concentration and cord serum EP levels between infants appropriate for gestational age (AGA) and small for gestational age (SGA).
- To investigate the relationship between EP levels and Hb concentration, and the influence of delivery mode on EP levels.
Main Methods:
- Capillary Hb concentration was measured on day one of life in 201 AGA and 99 SGA infants.
- Cord serum EP levels were analyzed.
- Infants were categorized by gestational age and delivery method (elective cesarean vs. uncomplicated vaginal delivery).
Main Results:
- Both AGA and SGA infants showed increasing Hb towards term (P < 0.01).
- SGA infants exhibited significantly higher term Hb levels (21.5 +/- 1.9 g/dl) than AGA infants (17.9 +/- 1.5 g/dl) (P < 0.001).
- Cord serum EP increased towards term similarly in both groups, unaffected by delivery mode. No correlation was found between cord EP and first-day PCV. Postnatal EP levels rapidly decreased, with none detected in healthy adults.
Conclusions:
- SGA infants achieve higher term hemoglobin concentrations, potentially due to factors like increased hypoxia and rapid growth.
- Erythropoietin levels rise towards term but do not directly correlate with immediate postnatal hemoglobin, suggesting complex regulatory mechanisms.
- Improved oxygenation after birth likely contributes to the rapid decline in erythropoietin levels.
Abstract:
Capillary Hb concentration on the first day of life was registered in 201 infants with weight appropriate for gestational age (AGA) and in 99 infants small for gestational age (SGA). In both groups Hb increased towards term (P less than 0.01), while the SGA infants reached higher Hb concentration at term (21.5 +/- 1.9 g/dl; mean +/- SD) than the AGA infants (17.9 +/- 1.5 g/dl) (P less than 0.001). The cord serum erythropoietin (EP) level increased towards term equally in both groups. Delivery did not seem to influence the EP level as same values were obtained in cord serum from infants delivered by elective cesarean section as after uncomplicated vaginal delivery. No correlation was found between cord serum EP and first day capillary PCV. Postnatally a rapid fall in the EP level occurred. In healthy adults no serum EP activity was detected. It is suggested that increasing hypoxia, rapid growth, and shift from hepatic to myeloid erythropoiesis may be related to the increasing Hb concentration and serum EP level towards term. Improvement of oxygenation during air breathing may cause the decreasing serum EP level after birth.