Abstract

Background: The study was established to define the prevalence of neonatal microcytosis and to estimate the incidence rate of alpha-thalassemia as its leading cause, in Tehran, Iran.

Materials and Methods: Overall, 800 neonates were selected from two populations of newborns and admitted neonates. Three hundred and sixty-one cord blood samples were obtained from deliveries in Mahdieh Hospital in April and May 2013. A second group of 439 neonates aged 1-5 days were subject to the study from admissions to the neonatal ward and neonatal intensive care units in Mahdieh Hospital between March 2011 and August 2014. All the included neonates were term, single, with normal birth weights. The admitted neonates suspected to have hemolytic anemia were excluded from the study. Microcytosis cut-off point was set at 95 fl.

Results: Prevalence of microcytosis was 2.5% in cord blood samples and 7.7% in admitted neonates. The admitted neonates showed a 3.28-fold higher risk of microcytosis compared to newborns. The average mean corpuscular volume was 104.6 ± 4.5  fl in newborns and 103.2 ± 6.0 fl in the admitted neonates. The admitted neonates had smaller and lower numbers of erythrocytes with higher mean corpuscular hemoglobin.

Conclusion: Prevalence of neonatal microcytosis was lower than expected in healthy newborns based on some previous studies, and therefore, alpha-thalassemia carriership as the main leading cause of neonatal microcytosis does not appear to be an urgent issue for mass screening to be considered. Selective screening should be taken into account as a more cost-effective option in neonatology wards.

the risk of sickle cell complications that is a common hemoglobin disorder in Southwest Iran. This study aimed at determining the incidence of Sickle Cell Disease (SCD) and other Hemoglobinopathies in newborn being at risk based on ethnic origin.
Materials and Methods: In this descriptive epidemiologic  study, between September 2013 and September 2015, 8363 newborn blood samples were tested in four maternity units from Ahvaz, Khoramshahr, Sosangerd and Dezful. Complete cell count and cellulose acetate electrophoresis at pH 8.4 were performed on each blood sample. Parent's clinical status was also checked for more information. Presence of an abnormal band in the EDTA treated samples were further confirmed by citrate agar gel electrophoresis and automated high performance liquid chromatography (HPLC). Results were analyzed statistically by the One-Way ANOVA analysis.
Results: Among 8363 screened samples, 118 (1.41 %) samples were heterozygous for Hb S, and four (0.047%) for Hb C; none of newborns were Hb SS homozygotes. The incidence of silent and alpha thalassemia minor based on RBC indices was nearly 10%.
Conclusion: Present findings indicated the high quality and considerable impact of conducted screening program starting in 2007 at significantly decreasing the prevalence of SCD among newborns born between 2013 and 2015. The results also showed that the neonatal screening for SCD was not weighed to add as a new program in national health network.