Effect of neonatal hemoglobin concentration on long-term outcome of infants affected by fetomaternal hemorrhage.

Abstract

BACKGROUND:

Fetomaternal hemorrhage (FMH) can cause severe morbidity. However, perinatal risk factors for long-term poor outcome due to FMH have not been extensively studied.

AIMS:

To determine which FMH infants are likely to have neurological sequelae.

STUDY DESIGN:

A single-center retrospective observational study. Perinatal factors, including demographic characteristics, Kleihauer-Betke test, blood gas analysis, and neonatal blood hemoglobin concentration ([Hb]), were analyzed in association with long-term outcomes.

SUBJECTS:

All 18 neonates referred to a Neonatal Intensive Care Unit of Kagoshima City Hospital and diagnosed with FMH during a 15-year study period. All had a neonatal [Hb] <7.5g/dL and 15 of 17 neonates tested had Kleihauer-Betke test result >4.0%.

OUTCOME MEASURES:

Poor long-term outcome was defined as any of the following determined at 12 month old or more: cerebral palsy, mental retardation, attention deficit/hyperactivity disorder, and epilepsy.

RESULTS:

Nine of the 18 neonates exhibited poor outcomes. Among demographic characteristics and blood variables compared between two groups with poor and favorable outcomes, significant differences were observed in [Hb] (3.6±1.4 vs. 5.4±1.1g/dL, P=0.01), pH (7.09±0.11 vs. 7.25±0.13, P=0.02) and base deficits (17.5±5.4 vs. 10.4±6.0mmol/L, P=0.02) in neonatal blood, and a number of infants with [Hb]≤4.5g/dL (78%[7/9] vs. 22%[2/9], P=0.03), respectively. The base deficit in neonatal arterial blood increased significantly with decreasing neonatal [Hb].

CONCLUSIONS:

Severe anemia causing severe base deficit is associated with neurological sequelae in FMH infants.

• Authors: Mizuho Kadooka, Hiromi Kato, Akihiko Kato, Satoshi Ibara, Hisanori Minakami, Yuko Maruyama
• Journal: Early human development (Early Hum Dev) Vol. 90 Issue 9 Pg. 431-4 (Sep 2014) ISSN: 1872-6232 [Electronic] Ireland
• PMID: 24964226 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 Elsevier Ltd. All rights reserved.

Chemical References

• Hemoglobins

Topics

• Female
• Hemoglobins (metabolism)
• Hemorrhage (complications)
• Humans
• Infant, Newborn
• Japan
• Maternal-Fetal Exchange
• Pregnancy