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da Silva Brito R, de Lima Barros LM, Moreira LW, Normando RN, de Jesus TB, de Souza Gonçalves M, Ramasawmy R, de Oliveira SF, da Silva KER, Fraiji NA, da Hora LF, de Abreu Netto RL, de Moura Neto JP. Basic biochemical and hematological parameters of structural hemoglobin variants in the postpartum women and their respective newborn from Manaus, Amazonas, Brazil. BMC Pregnancy Childbirth 2022; 22:936. [PMID: 36522644 PMCID: PMC9756781 DOI: 10.1186/s12884-022-05143-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/21/2022] [Indexed: 12/23/2022] Open
Abstract
The present study aimed at estimating the prevalence of structural hemoglobinopathies in newborn and describing the hematological and biochemical characteristics between postpartum women (PW) and their respective newborns (NB) at a public maternity hospital in Manaus, Amazonas state, Brazil. In total, 825 NB and 820 PW were included in the study. Hematological and biochemical analysis and screening of structural hemoglobinopathies were performed and compared in groups of individuals (NICU or not; hemoglobin genotypes; gestational age and prenatal). The age of PW ranged from 13 to 44 years old (mean of 23.7 ± 6.6 years), with 45.9% pregnant for the first time and 54.1% multiparous. Reported receiving prenatal care 88% and regarding the type of delivery, 47.7% had delivered by cesarean section. Among the births, 19.4% were born premature and 8.3% were admission to the neonatal intensive care unit (NICU). The male NB represented 53.4% of the total. Sickle cell trait (FAS) was found in 16 (1.94%) and heterozygous for D hemoglobin (FAD) in 6 (0.73%) newborns. A statistically significant values was found between the previous history of miscarriage and increase of Mean corpuscular volume (MCV) (p < .001), Red blood cell distribution width (RDW) (p = .003), total and indirect bilirubin concentration (p < .001) and LDL cholesterol (p = .004). Hemoglobin levels below 13.5 g/dL was found in 66% black newborns, compared with 15% of Afro-Brazilian and 5% of whites. The frequency of structural hemoglobinopathies was higher in African-Brazilian newborn babies (78%) and those who with low birth weight had a higher frequency of NICU (35.7%). Interestingly, underage mothers had a higher frequency of NB with low birth weight and premature birth. Postpartum women who had children carriers of FAS and FAD had a higher frequency of urinary tract infection (65.2%) and moderate anemia (23.8%). This study estimated for the first time the prevalence of structural hemoglobinopathies in NB in Manaus, Amazonas, Brazil. Despite the small prevalence of, we highlight the importance of early diagnosis of hemoglobin variants, contributing to the improvement of the quality of life of PW and your NB, reinforce the need to implement educational and prevention programs to raise awareness among the population and in order to counsel parents regarding the probability of having a child with abnormal hemoglobins homozygous as HbSS or HbCC.
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Affiliation(s)
- Roberta da Silva Brito
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | | | - Lilian Wallace Moreira
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | - Regina Neves Normando
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | - Thiago Bacha de Jesus
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Marilda de Souza Gonçalves
- grid.418068.30000 0001 0723 0931Fundação Oswaldo Cruz - Centro de Pesquisas Gonçalo Moniz, Salvador, Bahia Brazil
| | - Rajendranath Ramasawmy
- grid.418153.a0000 0004 0486 0972Fundação de Medicina Tropical Dr. Heitor Vieira Dourado, Manaus, Amazonas Brazil
| | - Stéfani Ferreira de Oliveira
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Keyla Emanulle Ramos da Silva
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Nelson Abrahim Fraiji
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil
| | - Larissa Feitosa da Hora
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - Rebeca Linhares de Abreu Netto
- grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
| | - José Pereira de Moura Neto
- grid.512139.d0000 0004 0635 1549Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas, Manaus, Amazonas Brazil ,grid.411181.c0000 0001 2221 0517Universidade Federal do Amazonas, Faculdade de Ciências Farmacêuticas, General Rodrigo Otávio Jordão Ramos Avenue, 6200 - Coroado I, Manaus, Amazonas CEP: 69067-005 Brazil
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de la Fuente-Gonzalo F, Nieto JM, Villegas A, González FA, Martínez R, Ropero P. Characterization of deletional and non-deletional alpha globin variants in a large cohort from Spain between 2009 and 2014. Ann Hematol 2019; 98:1537-1545. [PMID: 31025160 DOI: 10.1007/s00277-019-03696-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Accepted: 04/15/2019] [Indexed: 11/30/2022]
Abstract
The hemoglobinopathies are a group of disorders passed down through families (inherited) in which there is abnormal production or structure of the hemoglobin molecule. They are among the most common inherited diseases around the world. Those that produce abnormal hemoglobin are called structural hemoglobinopathies while thalassemia is another type of disorder that is caused by a defect in the gene production of the globin chains. In a study ambispective comprising 1623 patients, 153 subjects showed an abnormal hemoglobin and 1470 with hypochromic and microcytic anemia, and of these 1470, 23 patients were studied for simultaneously α-thalassemias and structural hemoglobinopathies. Among the α-thalassaemia cases, 1282 cases (87.2%) were deletional α-thalassemia, 172 cases (11.7%) were non-deletional α-thalassemia, and 16 cases (1.1%) were deletional and non-deletional α-thalassamias simultaneously. Thus, approximately 12% of the cases were non-deletional α-thalassaemia. Clinical diagnosis, only 19 severe cases (1 hydrops fetalis and 18 instances of Hb H disease), 1200 thalassamias traits, and 160 thalassaemia silent carriers were recorded within the α-thalassaemia. Regarding structural hemoglobinopathies, there were only 2 cases of hemoglobinopathies with low oxygen affinity and 1 case of hemoglobin M; the remaining 150 were silent hemoglobinopathies. Non-deletional α-thalassaemia represented 12% of all α-thalassemias in our region; the most common deletion in our area was the 3.7-kb deletions, followed by Asian --(SEA) and --(FIL). The alterations responsible for non-deletional α-thalassaemia are most represented by the Hph and Hb Groene Hart and, in the case of structural hemoglobinopathies, Hb Le Lamentin and Hb J-Paris.
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Affiliation(s)
| | - Jorge M Nieto
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
| | - Ana Villegas
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
| | - Fernando A González
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
| | - Rafael Martínez
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain
| | - Paloma Ropero
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, Spain.
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González Borrachero ML, de la Fuente-Gonzalo F, González FA, Nieto JM, Villegas A, Ropero P. [Delta⁰-thalassemia by insertion of 27 base pairs in δ-globin gene with decreased hemoglobin A₂ levels]. Med Clin (Barc) 2015; 144:312-6. [PMID: 25579773 DOI: 10.1016/j.medcli.2014.10.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 10/16/2014] [Accepted: 10/23/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND OBJECTIVE We describe a novel delta-thalassemia mutation causing decreased hemoglobin (Hb) A2 levels associated with Hb Watts, variant Hb resulting from a trinucleotide deletion in Spain. PATIENTS AND METHOD Hb variant analysis was performed by cation-exchange high performance liquid chromatography (HPLC) and capillary zone electrophoresis. Polymerase chain reaction and DNA sequence analyses were used to identify mutations in the δ- and α-globin genes. RESULTS Abnormal Hb was observed on capillary zone electrophoresis in Z6 and by cation-exchange HPLC a slower peak than HbA was observed at an retention time of 4.19min. This variant Hb is called Hb Watts [α2 74(EF3)Asp->0 or α2 75(EF4)Asp->0; HBA2:c.226_228delGAC]. The decreased HbA2 percentage owes to an insertion of 27nt between nt 83 and 84 of IVS-I of the δ-globin gene. CONCLUSIONS When analyzing a chromatogram, the possibility of the existence of delta-thalassemia or an HbA2 variant should be considered, apart from alfa-, beta-thalassemia and structural haemoglobinopathies. To this end, each of the peaks and their percentages should be considered to allow for correct interpretation and to avoid misdiagnosis as much as possible.
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Affiliation(s)
| | | | | | - Jorge M Nieto
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, España
| | - Ana Villegas
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, España
| | - Paloma Ropero
- Servicio de Hematología y Hemoterapia, Hospital Clínico San Carlos, Madrid, España.
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