Hemoglobin Analysis in the First Year of Life

BACKGROUND AND OBJECTIVES: In newborns and infants during their first year of life, there is a dynamic change in the fraction of hemoglobin (Hb). To apply Hb analysis as a phenotypic diagnosis of thalassemia in newborns and infants, we need normal values of each Hb fraction for reference. METHODS: Seventeen cord bloods from normal deliveries were collected for analysis. One hundred and thirty-seven infants from the pediatric outpatient clinic were recruited and were categorized by their ages into a series of short periods (month±2 weeks). Both alpha and beta thalassemia carriers detected were excluded. Samples with an Hb level less than 10.0 g/dL were also excluded. The proportion of Hb A (α(2)β(2)), A(2) (α(2)δ(2)), and F (α(2)γ(2)) was obtained from high-performance liquid chromatography and analyzed according to its categorized periods. RESULTS: There were 90 (58.4%) specimens left for evaluation. The percentage of Hb A, A(2), and F gradually changed with increasing age. The percentage of Hb A was 21.14±7.04% (mean±SD) in cord blood and increased substantially to 83.38±1.31% at the sixth month. The level was sustained thereafter. The incremental pattern of Hb A(2) was similar to Hb A. The value was 0.32±0.19% at the beginning and reached a plateau with 2.78±0.25% at the sixth month. The percentage of Hb F started at 78.39±7.59% in cord blood and decreased rapidly in the first 6 months. CONCLUSIONS: The data possibly can be applied as quick guidance for interpretation of Hb analysis in newborns and infants during their first year of life.