European Journal of Biomedical and Pharmaceutical Sciences

NEONATAL SCREENING FOR ANAEMIA IN HEALTHY, FULL-TERM IRANIAN NEWBORNS: IS THERE ANY INDICATION

Mahdi Shahriari, Narjes Pishva*, Reza Bahrami, Alimohammad Alemansuri, Amir Naghshzan

ABSTRACT

Background: The high incidence of alpha thalassemia, G6PD deficiency and spherocytosis are three reasons that newborn screening should be routine in all delivery rooms in order to decrease morbidity. The object of this study was neonatal screening for anaemia in healthy, full-term Iranian new-borns. Materials and Methods: One thousand neonates were screened over a nearly three-year period for detection of the cause of anaemia. All neonates were Iranian and lived in Fars Province, southern Iran, and were healthy and full term. This study was conducted in Zeinabiieh and Hafez Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. The screening was performed on cord blood samples collected on EDTA and the method was approved by the Ethical Committee. After sample collection, complete blood cell count, osmotic fragility test and haemoglobin electrophoresis were done for each sample. Results: Total prevalence of causes of anaemia in this neonatal screening programme was 12.2 %; the most prevalent one was alpha thalassemia (6.4 %), followed by hereditary spherocytosis (4.8 %) and sickle cell anaemia (1.2 %). The total analysis for detection of alpha thalassemia suggested that screening methods by mean corpuscular volume (MCV) ≤ 97 fl, mean corpuscular haemoglobin (MCH) ≤ 29, and haemoglobin level ≤ 16 g/dl plus MCHC > 35, were the appropriate cut-off points for our population. Conclusion: Our study does not endorse previously described cut-off points for the mean corpuscular volume, or the mean corpuscular haemoglobin as indexes for screening of alpha thalassemia, or haemoglobin as a screening index for hereditary spherocytosis.

Keywords: Haemoglobinopathy, neonatal screening programme, alpha thalassemia, hereditary spherocytosis, sickle cell anaemia.