Cord Blood Hemoglobin Research Articles

The relation between maternal and cord serum iron levels and its effect on fetal growth in iron deficient mothers without malarial infection.

In this relatively iton deficient population both multiparous and primiparous pregnant women had similar serum iron levels. The mothers' levels had a linear correlation with the cord serum levels, but the lowest mean cord levels were above 100 mug./dl. maternal and cord blood haemoglobin levels,birthweights and placental weights showed no constant relation to the serum iron levels, and even in anaemic mothers the fetus was relatively non-asaemic with a haemoglobin level aroun 13 g./dl. In non-anaemic mothers the cord blood haemogloin rose rapidly and progressively.

Assessment of severity of haemolytic disease of the newborn at time of birth.

A new cord blood factor has been suggested as a measure of the severity of haemolytic disease of the newborn at birth. One hundred and seventy three cases of Rhesus iso-immunisation have been classified as mild, moderate and severe according to the readings of Optical Density Difference of bilirubin in the liquor amnii and correlated with the cord blood haemoglobin, cord blood serum bilirubin, and the new cord blood factor. The new cord blood factor gave the best correlation.

Influence of intrauterine haemolysis on the amniotic fluid phospholipid concentration.

The relationship between surfactant synthesis measured by amniotic fluid lecithin concentration and L/S ratio, and the degree of intrauterine haemolysis as judged by the Liley optical density difference, has been studied in 125 samples from 62 rhesus immunized pregnant women. In forty cases where the samples were obtained within one week of delivery, the results have been correlated with cord blood haemoglobin concentrations. There is evidence that a mild intrauterine haemolytic process may stimulate surfactant production while severe intrauterine haemolysis may be inhibitory in some cases. Intrauterine anaemia did not seem to have any effect upon respiratory function after birth as long as the L/S ratio was adequate.

The clinical value of amniotic fluid analysis in pregnancies complicated by Rh-isoimmunization or hepatosis.

605 samples of amniotic fluid were obtained by abdominal amniocentesis in 363 late pregnancies. The liquor was analysed with respect to ΔE450 (the optical density at 450 nm), progesterone and total protein content. On 172 samples measurements of the acid and alkaline phosphatase activity were also performed. Most of the samples came from pregnancies complicated by isoimmunization, but the material also contained samples from women with hepatosis gravidarum or other complications as well as from normal pregnancies. The measurements have been studied in relation to duration of pregnancy, cord blood haemoglobin levels, cord serum bilirubin levels, infant birth weight, maternal serum bilirubin levels, maternal alkaline phosphatase levels, maternal age, order of pregnancy, maternal and infant blood groups. For part of the series the relationships between the parameters were studied by multiple regression analysis. The results indicate a rather weak correlation between infant cord blood haemoglobin levels and the other parameters. The ABO blood groups of mother and infant influence the levels of cord blood haemoglobin, cord serum bilirubin and amniotic fluid total protein. Amniotic fluid progesterone and ΔE450 values are correlated to amniotic fluid total protein levels. Low ΔE450 values indicate that the fetus is mature. Determinations of ΔLE460 before the 37th week show a better correlation with the condition of the infant than later ones. Order of pregnancy influences the total protein content of amniotic fluid in normal pregnancies. Determinations of acid and alkaline phosphatases in amniotic fluid do not give any clinically important information in cases of isoimmunization. Meconium contamination strongly increases alkaline phosphatase activity. Attempts to use the rapid method of Brown for oestrogen determinations in amniotic fluid proved to be difficult for technical reasons.

Free zone electrophoresis of amniotic fluid in normal pregnancies and in pregnancies complicated by haemolytic disease.

Abstract. Sixty‐four samples of undialysed amniotic fluid were analysed in a free zone electrophoresis apparatus equipped with an ultra‐violet (UV) scanning attachment for quantitative determinations of the protein concentrations. Total protein concentrations were measured by a biuret method. The electrophoretic patterns of amniotic fluid were generally simpler than those from maternal or cord serum or plasma. The albumin fraction showed the highest correlation to total protein levels in amniotic fluid both in normal pregnancies and in pregnancies complicated by haemolytic disease. Samples from pregnancies complicated by moderate to serious haemolytic disease showed a tendency to a more rapid decrease of the main protein fractions during the later phase of pregnancy. No significant connections could be found between the main protein fractions and cord blood haemoglobin or bilirubin concentrations. A probably significant correlation existed between the values for the albumin fraction and the values for amniotic fluid bile pigments (ΔE450) in normal pregnancies but not in pregnancies with haemolytic disease. A high nonprotein peak in the patterns from amniotic fluid was found to consist mainly of uric acid. The size of this peak was positively correlated with infant birth weight and negatively correlated with concentrations of albumin and total protein in normal pregnancies. Polyacrylamide gel gradient electrophoresis of some samples showed amniotic fluid to be rich in proteins with relatively low molecular weights.

Estimation of antibody protein in amniotic fluid to predict severity in rhesus haemolytic disease.

SummaryUsing rhesus antibody quantitation in amniotic fluid samples as a supplement to Liley's spectrophotometric method, the accuracy of prediction of severity of rhesus haemolytic disease has been improved from 77 to 90 per cent. When the antibody protein level was less than 0.2 μg. per ml. the cord blood haemoglobin value was more than 11.0 g. per 100 ml. However, when the antibody protein value was greater than 0.6 μg. per ml. the cord blood haemoglobin level was less than 8.0 g. per 100 ml. In 32 of 34 rhesus (D) negative babies the amniotic fluid contained neglible amounts of anti‐D.

Urinary excretion of estriol and 15α-hydroxyestriol in complicated pregnancies

Urinary excretion of estriol and 15α-hydroxyestriol (estetrol) was determined in 89 women whose pregnancies were complicated by toxemia, diabetes mellitus, Rh isoimmunization, intrauterine fetal death, or recurrent intrahepatic cholestasis of pregnancy. More than 300 urine samples were analyzed by a highly specific gas chromatographic method and the results were compared with values during normal pregnancies. The 2 estrogens usually gave the same correct information on the fetal state. In some cases of toxemia, the amount of estetrol was more reliable for monitoring the intrauterine fetal condition than that of estriol. In pregnancies complicated by Rh isoimmunization, the urinary excretion of estetrol bore a linear correlation to the cord blood hemoglobin concentration. The amount of estriol in the same maternal urine samples showed no correlation with the cord hemoglobin.

Incidence and mechanism of neonatal jaundice related to glucose-6-phosphate dehydrogenase deficiency.

Extract: In three population surveys in Greece, the incidence of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and neonatal jaundice was examined in randomly selected male newborns. The incidence rate of G-6-PD deficiency was 2.92% in the Alexandra survey (population of Athens and southern Greece), 4.93% in the Lesbos survey and 12.5% in the Rhodes survey. In all surveys, severe jaundice without blood group incompatibility or low birth weight appeared much more frequently in G-6-PD-deficient than in normal newborns, but there were striking differences. In Lesbos, severe jaundice was found much more frequently in both G-6-PD-deficient and normal groups than in comparable groups in the other two surveys. Similarly, at 4 days of age, values for serum bilirubin in control groups were 9.43±4.39 mg/100 ml in Lesbos and 7.88±4.8 mg/100 ml in Rhodes (p <0.05). These differences indicate that in Lesbos, an unknown icterogenic factor alone increases the incidence of neonatal hyperbilirubinemia and, in conjunction with G-6-PD deficiency, causes severe neonatal jaundice (serum bilirubin values higher than 16 mg/100 ml) in 43% of G-6-PD deficient infants. In the Rhodes survey, values for hemoglobin and serum bilirubin and reticulocyte count in the G-6-PD-deficient group were compared with values in the cord blood and in samples of blood drawn on the 4th day of life from the control group. The G-6-PD-deficient group had lower hemoglobin values and higher serum bilirubin values than the control group. The mean values (g/100 ml) for hemoglobin in cord blood were 14.42±1.24 and 15.36±1.36 in the G-6-PD-deficient and control groups, respectively. In samples obtained at 4 days of age, the values were 15.6±1.34 and 16.65±1.37, respectively, in the two groups. The mean values (mg/100 ml) for serum bilirubin in cord blood were 1.98±0.64 and 1.68±0.42, respectively, in the two groups. At 4 days of age, the values were 9.86±6.6 and 7.88±4.8, respectively. These results indicate a diminished life span of G-6-PD-deficient erythrocytes in the fetal and neonatal period. Speculation: This study demonstrates the existence in some newborn populations of an icterogenic factor unrelated to blood group incompatibility or G-6-PD deficiency. Further studies are needed to determine the hemolytic or hepatic nature of this factor and whether this factor interacts with ABO incompatibility or prematurity. In this work, the relation of this factor to G-6-PD deficiency has been studied.

Hemoglobin FHouston: A Fetal Variant

AbstractA fetal hemoglobin variant, designated hemoglobin FHouston, was found in the cord blood sample of a healthy, term Negro infant. The variant, comprising about 15 per cent of the total cord blood hemoglobin, diminished concomitantly with hemoglobin F, and it was barely detectable in the blood when the infant was 4 months old. The hemolysates of the parents and two siblings resolved into the usual adult pattern, but a trace amount of a fraction similar to hemoglobin FHouston was present in the father's hemolysates and not in the mother's.The ultraviolet absorption spectrum indicates that hemoglobin FHOUSTON contains γ polypeptide chains, and immunologic studies reveal the presence of both α and γ chains. In hybridization tests the alteration appears in the γ chain.Peptide chromatograms of hemoglobin FHouston indicated the presence of α and γ chains, but failed to reveal an abnormality. Amino acid analyses suggest that there may be a substitution of an alanyl for a glutamyl residue.

A Comparison of the Percentage of Fetal Hemoglobin in Human Umbilical Cord Blood as Determined by Chromatography and by Alkali Denaturation

A Comparison of the Percentage of Fetal Hemoglobin in Human Umbilical Cord Blood as Determined by Chromatography and by Alkali Denaturation

A Comparison of the Percentage of Fetal Hemoglobin in Human Umbilical Cord Blood as Determined by Chromatography and by Alkali Denaturation

AbstractA comparison has been made of the determination of fetal hemoglobin in human umbilical cord blood by column chromatography and alkali denaturation. A careful study has also been made of the variables that control the accuracy and precision of the methods. Minor modification has led to much improved control of the 1-minute alkali denaturation procedure.The percentage of fetal hemoglobin in the umiblical cord blood of full term infants has been found to cover a far narrower range than is commonly reported. By chromatography, the average is 85.5 per cent with a range from 79 to 91 per cent that includes more than 95 per cent of normal full term infants. By alkali denaturation, the average is 74.0 per cent with a range from 63 to 87 per cent.Possible correlations with several clinical parameters have been examined. The highest correlation by both methods of determination occurred in the group of 12 samples from infants with a duration of gestation less than 37 weeks. In this group the linear correlation with weight was greater than 0.6.The precision and accuracy of the chromatographic method recommend it in the study of such subjects as prematurity, twinning, dysmaturity, intrauterine growth retardation, and infants of diabetic mothers.

Studies on Hemoglobin: 1. Antigenic Properties of Human, Canine and Rabbit Hemoglobin Solutions

AbstractSpecific antisera with high antibody titers could be prepared against adult, cord blood, dog and rabbit hemoglobin solutions. These sera were employed to study the antigenic properties of the above hemoglobins.Common antigenic properties could be detected between hemoglobin solutions prepared from human, canine and rabbit blood.No immunologic difference could be found between the fetal fractions of adult human blood, cord blood and thalassemia patients' hemoglobin solutions.

Absence of haemoglobin A2 in an adult.

HAEMOGLOBIN A2, the minor component of normal adult haemoglobin, amounts to about 2.5 per cent of the total haemoglobin; it can be distinguished from the major adult component, haemoglobin A1, by its electrophoretic and chromatographic properties. Recent investigations have shown that haemoglobin A2 consists of two types of polypeptide chains: the α-chain, identical with the α-chain of haemoglobins A1 and F, and the δ-chain, which differs in constitution from the corresponding chains of haemoglobin A1, (the β-chain) and F (the γ-chain)1,2. A two-fold increase of the normal percentage of haemoglobin A2 occurs in the usual type of β-chain thalassaemia trait, prevalent in Greece3, while a decrease is observed in haemoglobin-H disease. A decrease of the A2 fraction down to 1 per cent has been observed as a reversible phenomenon in iron-deficiency anaemia4. Traces of haemoglobin A2 can be detected in cord blood haemoglobin by the application of special techniques.

Studies of Antisera to Adult Human Hemoglobin

Summary Of 20 rabbits immunized with adult human hemoglobin, 10 eventually gave good precipitating antisera, 5 gave weak antisera and 5 had not produced precipitins after three courses of injections. When mixed with hemoglobin all the antisera gave red precipitates and were able to precipitate completely adult and cord blood hemoglobin in optimal proportions or antiserum excess. The antisera did not agglutinate human red cells. Three of six antisera tested were able to annul the action of carbonic anhydrase. Absorption experiments with two antisera showed a serological distinction between the major hemoglobin components of a cord blood and an adult blood. Reactions of the antisera suggest the presence of two or more antigenically distinct hemoglobins in a single sample of blood from one adult.

Inhomogeneities in Alkali-Resistant Hemoglobin. Demonstration of Zone Electrophoretic Differences Using a Cationic Detergent Electrolyte

Abstract Trimethyloctadecyl ammonium chloride, a cationic active detergent electrolyte, when added to starch gels before electrophoresis, caused selected alteration in the migration rates of alkali-resistant hemoglobin. Other red blood cell pigments were not similarly affected. Electrophoretic inhomogeneity of cord blood and thalassemia hemoglobin was noted. New components of cord blood hemoglobin were revealed by the method. A new component in the hemoglobin of cases of severe thalassemia was demonstrated.

The evaluation of the partial absorption test for Rh antibodies in the prognosis of haemolytic disease of the newborn.

SummaryThe partial absorption test for titrating Rh antibodies in the maternal serum has been evaluated as a prognostic tool in a series of 290 cases of infants born to Rh‐immunized women. The P.A. test enables a more accurate prognosis to be made of the outcome for the infant than if the indirect antiglobulin titre of the maternal serum is used alone.The statistical coefficient of correlation between the P.A. titre of the maternal serum at the time of birth and cord blood haemoglobin for liveborn Rh‐positive infants is ‐0.72.The P.A. titre is unreliable in predicting stillbirths unless regular titrations have been carried out at least from the twentyfourth week of pregnancy. The unreliability is due to the rapid fall in P.A. titre in many cases after the foetus has died in utero. However, if the P.A. titre at the end of the second trimester is 1 : 64 or higher, the outcome is almost invariably fatal.The use of the P.A. test in conjunction with the ordinary indirect antiglobulin titrations of the maternal serum enables a more accurate discrimination to be made between mild and severe cases of hæmolytic disease of the newborn. It also makes possible the more reliable diagnosis of an Rh‐negative infant in cases in which the father is known to be heterozygous D/d, and is a valuable guide for giving advice to parents of Rh‐affected infants on when to start another pregnancy.It is recommended that exchange‐transfusion should be carried out in all cases in which the maternal indirect antiglobulin titre at the time of birth is 1 : 256 or higher. Exchange‐transfusion is not warranted if the maternal indirect antiglobulin titre is less than 1 : 128 at the time of birth. Where the maternal indirect antiglobulin titre is 1 : 128, exchange‐transfusion is not necessary if the P.A. titre is zero.

THE EVALUATION OF CORD-BLOOD HEMOGLOBIN, RETICULOCYTE PERCENTAGE AND MATERNAL ANTIGLOBULIN TITER IN THE PROGNOSIS OF HEMOLYTIC DISEASE OF THE NEWBORN (ERYTHROBLASTOSIS FETALIS)

An unselected series of 218 consecutive pregnant women in whom Rh antibodies were detected by means of a standardized antiglobulin test has been studied to evaluate the prognostic significance of values for cord-blood hemoglobin, reticulocyte percentage and maternal antibody titer at term. Twenty-four of the women gave birth to Rh-negative infants, 35 to stillborn infants, the majority of whom were severely macerated, and 159 to liveborn Rh-positive infants. All but three of the Rh-positive liveborn infants who were not moribund at birth were exchange-transfused if the maternal titer at term was 1:128 or higher. Of the 159 Rh-positive liveborn infants, 19 subsequently died, 5 of these being in the untreated group. The remainder were alive and well at least 1 month after birth. The antibody titer of the maternal serum at term determined by the indirect antiglobulin technique is not quite such a good prognostic index of the chance of survival of liveborn Rh-positive infants as either values for cord-blood hemoglobin or reticulocyte percentage. Titration values of the maternal serum have the distinct advantage that they can be determined before birth, and so give guidance in the management of the case, including the early induction of labor. A statistical comparison of the effectiveness of treatment showed that the lower neonatal death rate achieved in the present series was not significantly different from that in comparable series in England and America. Comparison with results published for a comparable American series, where the prognostic significance of maternal antibody titer at term as determined by the plasma-albumin method was evaluated, suggests that the indirect antiglobulin technique for titrating the antibodies in the maternal serum is not only more sensitive than the plasma-albumin method, but it achieves a more clear-cut separation between mild and severe cases. In consequence the indirect antiglobulin technique gives titration values of greater prognostic significance. Once the child is born, prognosis based on a combination of either maternal antibody titer with values for cord-blood hemoglobin or reticulocyte percentage is more accurate than one based on maternal antibody titer alone.

Haemoglobin in Cord Blood in Normal and Prolonged Pregnancy

<h3>Introduction</h3> Firefighters are responsible for the safety of citizens, and perform functions that include fire suppression and emergency medical services (EMS). As such, they are exposed to physical or chemical hazards that lead to high rates of occupational injuries. Despite a plethora of studies, there have been only a few systematic investigations to identify factors influencing occupational injuries among firefighters. In this study, which is based on a survey of all Korean firefighters, we aimed to investigate the existence of a correlation between job stress and occupational injury among firefighters. <h3>Methods</h3> Cross-sectional study was conducted via a survey targeting firefighters in South Korea between July and November 2007. A questionnaire was mailed to 30 630 firefighters; 25 615 (83.6%) responded. Statistical analysis was performed using the SAS 9.2 software (SAS Institute Inc., Cary, NC, USA). <h3>Results</h3> Among fire suppression personnel, high job demands (OR=1.49, 95% CI: 1.25 to 1.77), high interpersonal conflicts (OR=1.18, 95% CI: 1.02 to 1.37), a poor organisational system (OR=1.33, 95% CI: 1.14 to 1.55), and a negative workplace environment (OR=1.41, 95% CI: 1.21 to 1.64), and high job demands (OR=1.22, 95% CI: 1.01 to 1.47) were associated with the occurrence of occupational injury. Among emergency medical services personnel, high job demands (OR=1.26, 95% CI: 1.03 to 1.54), high interpersonal conflicts (OR=1.40, 95% CI: 1.19 to 1.66), a poor organisational system (OR=1.55, 95% CI: 1.30 to 1.85), lack of reward (OR=1.43, 95% CI: 1.21 to 1.69) and a negative workplace environment (OR=1.30, 95% CI: 1.10 to 1.54) were associated with the occurrence of occupational injury. <h3>Conclusion</h3> High job stress among firefighters was associated with both the occurrence of occupational injury, and also with an increased frequency of injuries. Therefore, job stress should be addressed to prevent occupational injuries among firefighters.

IRON METABOLISM

THE CLINICIAN has long been aware of the fact that iron deficiency anemia is most prevalent during infancy. Continuing studies of iron metabolism have disclosed many factors which help explain the basic mechanisms of the anemia and the peculiar vulnerability of the infant. The following comments pertain to a review of the subject appearing in this issue of Pediatrics. The concept that the baby is born with "iron stores," in terms of reserve depots, is no longer tenable. Almost the entire quota of iron with which the baby begins life is that contained in his circulating hemoglobin. This initial endowment is influenced by three major factors: 1) the length of gestation; 2) the amount of blood transferred from placenta to infant in the first few minutes after delivery, and 3) prenatal factors affecting intrauterine hematopoiesis, an aspect which may be highly significant since even in normal full-term infants the concentration of hemoglobin in cord blood has been found to vary within a range of 5 gm./100 ml. of blood.