Postnatal Fetal and Adult Hemoglobin Synthesis in Preterm Infants Whose Birth

A B S T R A C T To determine if environmental factors could effect the switchover from fetal hemoglobin (HbF) to adult hemoglobin (HbA) synthesis, studies were carried out on blood samples from eight infants born at <1,000 g, when they had reached their postconceptional age corresponding to term. All of these infants required prolonged intensive care, multiple blood transfusions, and two required exchange transfusions. Several were ventilated mechanically for 60 d and two infants had bronchopulmonary dysplasia at the time of the study. The blood samples were incubated in an amino acid mixture containing ['4C]leucine followed by column chromatography on DEAE Sephadex for separation of radioactive HbA and HbF. In spite of the extreme prematurity and poor growth of these sick infants, the proportional synthesis of HbF and HbA, as determined by the incorporation of [14C]leucine during the erythrocyte incubations, was characteristic of the period of human development from which the erythrocytes were obtained.