364 SPECTROPHOTOMETR1C MEASUREMENT OF FETAL HEMOCLOBIN(HbF) IN TERM AND PRETERM NEWBORNS: NORMAL VALUES AND RELATION TO INTRA-AND EXTRAUTERINE VARIABLES (DISEASES, DIAGNOSTICS, GESTATIONAL AGE)

摘要

OBJECTIVE: Spectrophotometric analysis of HbF can now be obtained from 30μI blood with the OSM 3 (Radiometer). No normal values of HbF in larger groups of preterm and term infants, the influence of HbF on pulse-oximetry readings, and the relation of HbF to the practice of intensive care as to diseases as BPD, maternal smoking etc. have been determined yet (1).METHODS: In 239 neonates (26th to 42 week GA) we measured HbF on day 1 (cross sectional study), in 162 neonates (32nd to 42nd week GA) we measured HbF at least once a week until discharge (longitudinal study) to look for influences of the extrauterine life on the course of HbF decrease. In 103 preterm infants we looked for the influence of HbF on pulse oximetry readings comparing pulse oximetric and cooximetric readings. In individual patients with BPD, gest.diabetes, growth retardation, and maternal smoking we followed HbF consecutively for at least 4 weeks to detect influences on the decrease of HbFRESULTS: 1. No statistical difference (total overlapping of SEM) between our cross sectional ind longitudinal study could be observed. 2. Upto the 35 th week HbF is 100%, decreasing quickly between 38th and 42nd week to 80%, extrauterine life and procedures have no influence 3.pulse oximetry in patients with 100%HbF reads 1.8%(mean) higher then cooximetry 4. BPD,maternal smoking, growth retardation, and diabetes seem to diminish the decrease of HbF. CONCLUSION: The amount of fetal hemoglobin in preterm infants is higher then older literatur data show. It has to be measured and considered for careful evaluation of oxygenation status in these children and for the interpretation of pulse oximetry readings.REF: 1.Netzel and M?ller, PerinatalMedizin 5:126, 1993