The switch from haemoglobin F to A: the time course of qualitative and quantitative variations of haemoglobins after birth.

The time course of the transition from HbF to HbA production in the postnatal period has been studied. The description is based on the time-dependent pattern of total haemoglobin and of HbF observed in an 8 months follow-up of 25 premature newborns. The absolute amount of HbF decreases exponentially from birth to approximately 25 weeks (from 15.56 +/- 0.48 g/dl to 0.66 +/- 0.08 g/dl), at a weekly rate of approximately 16%. On the other hand, HbA shows a biphasic pattern: first it decreases slightly from birth to 6 weeks (from 4.09 +/- 0.32 g/dl to 2. 63 +/- 0.33 g/dl); afterwards it increases exponentially at a weekly rate of 5% up to a plateau value, until HbF is almost completely replaced by HbA. Therefore the total haemoglobin decreases exponentially from birth to approximately constant for the next 6 weeks, and thereafter it increases very slowly. From these data, two distinct phases of postnatal erythropoiesis can be identified: the first (from birth to 6 weeks) is characterized by a decrease in the total amount of haemoglobin produced whereas in the second there is an alteration in the relative proportions of HbF and HbA being synthesized.