Fetal Hemoglobin Levels in Premature Newborns. Should we Reconsider Transfusion of Adult Donor Blood?
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Read the article on jpedsurg.org ↗Article · Apr 2021 · 1 min read
In brief
In brief
Study demonstrates that fetal hemoglobin levels in extremely premature newborns drop significantly after transfusion with adult donor blood, from 92% to 61% after one transfusion and 36% after two. Findings raise questions about whether maintaining higher fetal hemoglobin through alternative transfusion strategies could improve outcomes in this vulnerable population.
Written by the GCMD Library team from the article.
Purpose
The aim of this study was to assess the percent decrease in fetal hemoglobin (HbF) after transfusion of adult-derived donor packed red blood cell (pRBC) units in extremely low gestational age newborns (ELGANs).
Methods
Control percent fetal hemoglobin (%HbF) levels were measured in newborn cord blood or peripheral blood samples in non-transfused patients prior to elective surgery. ELGANs were followed prospectively and %HbF was measured on residual post-test complete blood count (CBC) specimens. ELGAN %HbF values were compared to the control population and transfusions were recorded.
Results
Initial mean %HbF in ELGANs (n=16) was 92.2±1.3% (range 90.2-95.1%), which is similar to the control group (n=25). Mean levels dropped to 61.1±11.1% (range 34.2-73.2%) after a single pRBC transfusion (n=9) and to a mean of 35.6±6.3% after an additional transfusion (n=5). %HbF levels trended upwards if no additional transfusions were given, but levels still remained lower than expected for gestational age through discharge (n=85 samples).
Conclusions
Percent fetal hemoglobin concentrations in ELGANs decrease precipitously after transfusion with adult donor pRBCs. Further studies are needed to evaluate the benefit of maintaining higher fetal hemoglobin concentrations in these patients and whether administration of HbF rather than adult donor pRBCs would improve patient outcomes.