Influence of Foetal Haemoglobin Dynamics on the Oxygen Content in the Blood of Full-Term and Premature Newborns
DOI:
https://doi.org/10.37482/2687-1491-Z253Keywords:
foetal haemoglobin, hypoxia, haemoglobin’s affinity for oxygen, neonatal period, full-term newborns, premature newborns, infants, blood transfusionsAbstract
There is limited research into the influence of foetal haemoglobin (HbF) dynamics in the neonatal period on the regulation of oxygen status in healthy full-term newborns and premature newborns with morphofunctional immaturity and low body mass. Analysis of the variability of oxygenation under the influence of biological and pathological blood transfusion factors, as well as HbF dynamics helps detect the mechanisms of development of hypoxic damage. The purpose of this study was to detail the effect of changes in the foetal haemoglobin fraction on the dynamics of oxygenation parameters during the neonatal period. Materials and methods. We analysed medical documentation of patients in the neonatology and intensive care departments of Nizhny Novgorod Regional Children’s Clinical Hospital for the period of 2019–2021. A total of 712 indicators of oxygen transport were determined in 198 neonatal patients: 337 in full-term and 375 in premature newborns. Further, we conducted 226 tests looking into changes in the oxygen status in 39 neonates and infants (29–60 days old) given and not given blood transfusions. A comparative analysis was performed of the dynamics of total haemoglobin concentration, oxygen-binding capacity of haemoglobin (CHb), HbF level, total oxygen content (ctO2) and haemoglobin’s affinity for oxygen (p50) in the arterialized capillary blood of neonates. Results. HbF level during the early neonatal period was higher in the group of preterm compared to full-term children (80.44 ± ± 7.75 vs 73.96 ± 2.91 %). Most actively (by 32.55 % from the baseline), in the neonatal period, HbF concentration decreased in premature infants (in full-term children, by 11.08 %). The quantitative and structural dynamics of HbF and haemoglobin from adults correlated with the changes in oxygen indicators (CHb, p50 and ctO₂). In full-term and premature children, we observed a negative dynamics of oxygenation parameters, with the exception of p50. Newborns and infants who were given blood transfusions during the neonatal period showed a decrease in HbF levels and an increase in p50 compared to patients that did not receive blood transfusions.
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