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At birth, hemoglobin F accounts for 50-95% of the infant's hemoglobin and at around 6 months after birth, hemoglobin A becomes the predominant type. By the time the baby is one year old, the proportions of different types of hemoglobin are expected to approximate the adult levels, with hemoglobin F reduced to very low levels. [4]
Anemia is a condition in which blood has a lower-than-normal amount of red blood cells or hemoglobin. [1] Anemia in pregnancy is a decrease in the total red blood cells (RBCs) or hemoglobin in the blood during pregnancy. Anemia is an extremely common condition in pregnancy world-wide, conferring a number of health risks to mother and child. [2]
Fetal hemoglobin can be used to screen for pregnancy complications in the fetus and pregnant person. Fetal hemoglobin can also be used to treat sickle cell anemia. This hemoglobin is less likely to be affected by the disease because it has a higher affinity for oxygen. Hydroxyurea is used to increase the amount of fetal hemoglobin in an adult. [4]
Anemia of prematurity (AOP) refers to a form of anemia affecting preterm infants [1] with decreased hematocrit. [2] AOP is a normochromic, normocytic hypoproliferative anemia. The primary mechanism of AOP is a decrease in erythropoietin (EPO), a red blood cell growth factor.
Another method, human chorionic gonadotropin (hCG) determination, can detect maternal blood because maternal blood has high levels of hCG. [12] The hemoglobin alkaline denaturation test can detect the presence of maternal blood, which is indicated by a color change from red to brown when the sample is added to alkali reagent.
During pregnancy the plasma volume increases by 40-50% and the red blood cell volume increases only by 20–30%. [22] These changes occur mostly in the second trimester and prior to 32 weeks gestation. [24] Due to dilution, the net result is a decrease in hematocrit or hemoglobin, which are measures of red blood cell concentration.
Hemoglobin Portland II (also referred to as ζ 2 β 2 or HbE Portland-2) is a form of hemoglobin existing at low levels during embryonic and fetal life, composed of two zeta chains and two beta chains. It is quite unstable, more so than even hemoglobin Gower 1, and breaks down very rapidly under stress. [4]
These gamma globins bind to form hemoglobin Barts. [1] It is produced in the disease alpha-thalassemia and in the most severe of cases, it is the only form of hemoglobin in circulation. In this situation, a fetus will develop hydrops fetalis and normally die before or shortly after birth, unless intrauterine blood transfusion is performed.