Switch from fetal to adult hemoglobin and 2,3-DPG in normal and premature infants.

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Undrstanding the hemoglobin switching regulation mechanism in extremely premature infants is particularly important understanding the extrauterine adaptation of the infants. In this study, we sought to identify factors influencing oxygen affinity in fetal bood and neonatal blood and obtained these results.<BR>(1) Developmental aging is required for hemoglobin switching. The Hb F level was 91.3 % until the 26 th gestational week, but it gradully dropped to 72.8 % by the 38 th week.<BR>(2) Switching in premature infants (27 to 32 weeks) is delayed at least two weeks in comparison with full-term infants. In premature infants, 2, 3-DPG rises rapidly immediately after birth, changing oxygen affinity and adapting Hb F to a high oxygen environment.<BR>(3) A delay in the switching of fetal hemoglobin to adult hemoglobin was confirmed in IUGR (intrauterine growth retardation) intants. However, there is a compensatory increase in 2, 3-DPG for adaptation after birth.<BR>(4) A delay in 2, 3-DPG increase was observed in RDS (respiratory distress syndrome) infants, and oxygen affinity remained high.
近畿産科婦人科学会の論文