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Hyper high haemoglobin content in red blood cells and erythropoietic transitions postnatally in infants of 22 to 26 weeks' gestation: a prospective cohort study

Larsson, Sara Marie LU ; Ulinder, Tommy LU ; Rakow, Alexander ; Vanpee, Mireille ; Wackernagel, Dirk ; Sävman, Karin ; Hansen-Pupp, Ingrid LU orcid ; Hellström, Ann ; Ley, David LU and Andersson, Ola LU orcid (2023) In Archives of Disease in Childhood: Fetal and Neonatal Edition 108(6). p.612-616
Abstract
Objective Blood cell populations, including red blood cells (RBC) unique to the extremely preterm (EPT) infant, are potentially lost due to frequent clinical blood sampling during neonatal intensive care. Currently, neonatal RBC population heterogeneity is not described by measurement of total haemoglobin or haematocrit. We therefore aimed to describe a subpopulation of large RBCs with hyper high haemoglobin content, >49 pg (Hyper-He) following EPT birth.
Design Prospective observational cohort study.
Setting Two Swedish study centres.
Participants Infants (n=62) born between gestational weeks 22+0 to 26+6.
Methods Prospective data (n=280) were collected from March 2020 to September 2022 as part of an ongoing randomised... (More)
Objective Blood cell populations, including red blood cells (RBC) unique to the extremely preterm (EPT) infant, are potentially lost due to frequent clinical blood sampling during neonatal intensive care. Currently, neonatal RBC population heterogeneity is not described by measurement of total haemoglobin or haematocrit. We therefore aimed to describe a subpopulation of large RBCs with hyper high haemoglobin content, >49 pg (Hyper-He) following EPT birth.
Design Prospective observational cohort study.
Setting Two Swedish study centres.
Participants Infants (n=62) born between gestational weeks 22+0 to 26+6.
Methods Prospective data (n=280) were collected from March 2020 to September 2022 as part of an ongoing randomised controlled trial. Blood was sampled from the umbilical cord, at postnatal day 1–14, 1 month, 40 weeks’ postmenstrual age and at 3 months’ corrected age.
Results At birth, there was a considerable inter-individual variation; Hyper-He ranging from 1.5% to 24.9% (median 7.0%). An inverse association with birth weight and gestational age was observed; Spearman’s rho (CI) −0.38 (−0.63 to −0.07) and −0.39 (−0.65 to −0.05), respectively. Overall, Hyper-He rapidly decreased, only 0.6%–5.0% (median 2.2%) remaining 2 weeks postnatally. Adult levels (Conclusion Our results point to gestational age and birth weight-dependent properties of the RBC population. Future work needs to verify results by different measurement techniques and elucidate the potential role of differing properties between endogenous and transfused RBCs in relation to neonatal morbidities during this important time frame of child development.
Trial registration number NCT04239690. (Less)
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author
; ; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Disease in Childhood: Fetal and Neonatal Edition
volume
108
issue
6
pages
612 - 616
publisher
BMJ Publishing Group
external identifiers
  • pmid:37169579
  • scopus:85174642170
ISSN
1468-2052
DOI
10.1136/archdischild-2022-325248
language
English
LU publication?
yes
id
9c3fa1a2-2ef2-494f-94c8-c1ae78f6218a
date added to LUP
2023-05-13 12:41:54
date last changed
2024-02-20 08:39:48
@article{9c3fa1a2-2ef2-494f-94c8-c1ae78f6218a,
  abstract     = {{Objective Blood cell populations, including red blood cells (RBC) unique to the extremely preterm (EPT) infant, are potentially lost due to frequent clinical blood sampling during neonatal intensive care. Currently, neonatal RBC population heterogeneity is not described by measurement of total haemoglobin or haematocrit. We therefore aimed to describe a subpopulation of large RBCs with hyper high haemoglobin content, &gt;49 pg (Hyper-He) following EPT birth.<br/>Design Prospective observational cohort study.<br/>Setting Two Swedish study centres.<br/>Participants Infants (n=62) born between gestational weeks 22+0 to 26+6.<br/>Methods Prospective data (n=280) were collected from March 2020 to September 2022 as part of an ongoing randomised controlled trial. Blood was sampled from the umbilical cord, at postnatal day 1–14, 1 month, 40 weeks’ postmenstrual age and at 3 months’ corrected age.<br/>Results At birth, there was a considerable inter-individual variation; Hyper-He ranging from 1.5% to 24.9% (median 7.0%). An inverse association with birth weight and gestational age was observed; Spearman’s rho (CI) −0.38 (−0.63 to −0.07) and −0.39 (−0.65 to −0.05), respectively. Overall, Hyper-He rapidly decreased, only 0.6%–5.0% (median 2.2%) remaining 2 weeks postnatally. Adult levels (Conclusion Our results point to gestational age and birth weight-dependent properties of the RBC population. Future work needs to verify results by different measurement techniques and elucidate the potential role of differing properties between endogenous and transfused RBCs in relation to neonatal morbidities during this important time frame of child development.<br/>Trial registration number NCT04239690.}},
  author       = {{Larsson, Sara Marie and Ulinder, Tommy and Rakow, Alexander and Vanpee, Mireille and Wackernagel, Dirk and Sävman, Karin and Hansen-Pupp, Ingrid and Hellström, Ann and Ley, David and Andersson, Ola}},
  issn         = {{1468-2052}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{6}},
  pages        = {{612--616}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Archives of Disease in Childhood: Fetal and Neonatal Edition}},
  title        = {{Hyper high haemoglobin content in red blood cells and erythropoietic transitions postnatally in infants of 22 to 26 weeks' gestation: a prospective cohort study}},
  url          = {{http://dx.doi.org/10.1136/archdischild-2022-325248}},
  doi          = {{10.1136/archdischild-2022-325248}},
  volume       = {{108}},
  year         = {{2023}},
}