Study of fetal hemoglobin with different gestational age and birth weight of the newborn

Santosh Kumar Roy, Ajit Kumar Shrivastava, Prema Ram Choudhary


Background: In many parts of the developing country estimation of antenatal gestational age is still not possible and challenging condition of proper perinatal care. This study aimed to find out relationship between the gestational age and birth weight of the newborn with fetal hemoglobin concentration.

Methods: In this comparative study, we included 90 pregnant women who delivered their babies by normal vaginal delivery. Out of these 90 babies, 27 were preterm with gestational age 28-36 weeks, 55 were term with gestational age 37-41 weeks and remaining 8 were post term with gestational age of more than 41 weeks. All these 90 newborn infants were also divided into two groups: low birth weight (birth weight <2.5 kg) and birth weight ≥2.5 kg. Fetal hemoglobin was estimated by using alkali denaturation technique of Chernoff and Singer on appropriate spectrophotometer. Statistical analysis was performed using SPSS windows version 20.0 software.

Results: The total number of newborns were significantly (p<0.001) higher in term group and with normal birth weight group. Fetal hemoglobin level was significantly (p<0.0001) lower in term, post term and normal birth weight groups. Study showed a definite negative correlation between gestational age and the fetal hemoglobin concentration. Fetal hemoglobin level was gradually declining with increasing gestational age and birth weight.

Conclusions:  It is concluded from this study that the concentration of fetal hemoglobin decreases at the rate of 2.4% per week with considerable variation of values at every week of advancing gestational age. Hence level of fetal hemoglobin estimation can be taken as an important criterion for evaluation of gestational age.



Birth weight, Fetal hemoglobin, Gestational age, Infants

Full Text:



Wilson K, Hawken S, Murphy MSQ, Atkinson KM, Potter BK, Sprague A et al. Postnatal Prediction of Gestational Age Using Newborn Fetal Hemoglobin Levels. E Bio Med. 2017;15:203-9.

Jain AK. Text book of Physiology: blood. 3rd edn. (Vol-I). New Delhi: Avichal Publishing Company. 2007;135-40.

Boron WF. Structure and Function of hemoglobin. In: Boron WF, Boulpaep EL (editors). Medical Physiology: A cellular and molecular approach. 2nd Updated edition. Philadelphia (United States of America): Elsevier/Saunders. 2012;125.

Andrews KW, Savitz DA, Hertz-Picciotto I. Prenatal lead exposure in relation to gestational age and birth weight: A review of epidemiologic studies. Am J Industrial Med. 1994;26:13-32.

Schulman L, Smith CH. Fetal and adult hemoglobins in hemolytic disease of the new born. Am J Dis Child. 1954; 87(2):167-78.

Thomas S, Drew R, Ersser R, Hjelm M, Stephens A. Haemoglobin A/F Ratio in Neonates at 7 Days Correlated with Birth Weight and Estimated Gestational Age. Acta Haematol. 1987;78:144-8.

Noguera NI, Detarsio G, Pérez SM, Bragós IM, Lanza O, Rodríguez JH et al. Hematologic study of newborn umbilical cord blood. Medicina (B Aires). 1999;59(5 Pt 1):446-8.

Simon LV, Hashmi MF, Bragg BN. APGAR Score. In: Stat Pearls. Treasure Island (FL): Stat Pearls Publishing. 2020.

Singer K, Chernoff AI, Singer L. Studies on abnormal hemoglobins. I. Their demonstration in sickle cell anemia and other hematologic disorders by means of alkali denaturation. Blood. 1951;6:413-28.

Decosta EJ, Reis RA. Relationship of cord blood foetal haemoglobin to length of gestation and birth weight. Am. J. Obst Gynec. 1959;78:57-65.

Andrews BF, Willet GP. Fetal Hemoglobin concentration in the newborn: Index of maturity and as supportive evidence for maternal Fetal Transfusion. Am J Obstetr Gynecol. 1965;91(1):85-8.

Gupta HL, Singh H, Dhatt PS, Mehta HC, Verma KC. Relationship of cord blood foetal hemoglobin to birth weight and length of gestation. Indian J Med Res. 1973;61(6):903-9.

Garbie AB, Decosta EJ, Reis RA. Relationship of cord blood foetal haemoglobin to length of gestation and birth weight. Am. J. Obst Gynec. 1959;78:57-65.

Deshpande VL, Magar DM, Talib VH. Relationship of cord blood foetal haemoglobin to length of gestation and birth weight. J Obstet Gynecol India. 1974;5:653-4.

Cotton DG. Fetal Hemoglobin concentration in the newborn. Bri Jr Obst Gyanec. 1955;62:945.

Armstrong BG, Nolin AD, McDonald AD. Work in pregnancy and birth weight for gestational age. Br J Ind Med. 1989;46(3):196-9.

Ott WJ. Accurate gestational dating: revisited. Am J Perinatol. 1994;11(6):404-8.

Olsen SF, Olsen J, Frische G. Does fish consumption during pregnancy increase fetal growth? A study of the size of the newborn, placental weight and gestational age in relation to fish consumption during pregnancy. Int J Epidemiol. 1990;19:971-7.

Wilcox M, Mongeli M, Gardosi J. Clinical birth weight standards for a total population in the 1980. Int J Obstetr Gyenecol.1994;101(2):178-8.

Mongelli M, Gardosi J. Birth weight, prematurity and accuracy of gestational age. Int J Gynaecol Obstet. 1997;56:251-6.

Robertson CM, Svenson LW, Kyle JM. Birth weight by gestational age for Albertan liveborn infants, 1985 through 1998. J Obstet Gynaecol Can. 2002;24:138-48.

Walker J, Turnbull EPN. Haemoglobin and red cells in the human foetus; III. Foetal and adult haemoglobin. Arch Dis Child. 1955;30(150):111-6.

Terrenato L, Bertilaccio C, Spinelli P, Colombo B. The switch from hemoglobin F to A; the time course of qualitative and quantitative varuatuirn of hemoglobins after birth. Br J Haematol. 1981;47:31.

Al-Mufti R, Hambley H, Farzaneh F, Nicolaides KH. Fetal and embryonic hemoglobins in erythroblasts of chromosomally normal and abnormal fetuses at 10-40 weeks of gestation. Haematol. 2000;85(7):690-3.

Cochran-Black DL, Cowan LD, Neas BR. The relation between newborn hemoglobin F fractions and risk factors for sudden infant death syndrome. Arch Pathol Lab Med. 2001;125(2):211-7.

Fagan DG, Lancashire RJ, Walker A. Determinants of fetal haemoglobin in newborn infants. Archi Dis Childhood. 1995;72:111-4.

Abrahamo VA, Bromberg YM, Salzberge RM. Fetal and adult hemoglobin fractions in dizygotic twins. Exp Med Surg. 1956;14(2-3):130-2.