Modern Pediatrics. Ukraine. (2026).2(154): 59-63. doi: 10.15574/SP.2026.2(154).5963
Garayeva S. Z., Gasimova Y. A., Hasanguliyeva G. M., Ravikumar D.
Azerbaijan Medical University, Baku

For citation: Garayeva SZ, Gasimova YA, Hasanguliyeva GM, Ravikumar D. (2026). Hemoglobinopathies in neonates with intrauterine growth restriction: frequency and clinical implications. Modern Pediatrics. Ukraine. 2(154): 59-63. doi: 10.15574/SP.2026.2(154).5963.
Article received: Jan 06, 2026. Accepted for publication: Mar 16, 2026.

Hemoglobinopathies are among the most common inherited disorders worldwide and represent a significant cause of pediatric morbidity. However, their role in neonatal populations, particularly in infants with intrauterine growth restriction (IUGR), remains insufficiently studied.
Aim – to assess the frequency and clinical characteristics of hemoglobinopathies in neonates with IUGR.
Materials and methods. A total of 103 term neonates with IUGR (Main group) and 50 healthy term neonates (Control group) were examined. Hemoglobin fractions (HbF, HbA₁, HbA₂) were analyzed in umbilical cord blood. Screening for hereditary hemoglobinopathies, including alpha- and beta-thalassemia and structural hemoglobin variants (HbS, HbD, HbC, HbE), was performed using isoelectric focusing, capillary electrophoresis, and high-performance liquid chromatography. Follow-up assessments were conducted at 6 months of age. Statistical analysis was performed using standard methods, with p<0.05 considered significant.
Results. Neonates with IUGR demonstrated significantly lower levels of fetal hemoglobin (HbF) and higher levels of HbA₁ and HbA₂ compared with controls. Hemoglobinopathies were identified in 16 (15.5%) infants with IUGR, including alpha-thalassemia (2.91%), beta-thalassemia (7.77%), sickle cell trait (1.94%), homozygous beta-thalassemia (1.94%), and compound heterozygous forms. In contrast, only 2 (4.0%) cases of heterozygous hemoglobinopathies were detected in the Control group. The frequency of hemoglobinopathies was higher in symmetrical IUGR compared with asymmetrical forms.
Conclusion. Children with IUGR exhibit a significantly higher frequency of hemoglobinopathies and distinct alterations in hemoglobin fractions, suggesting a potential role of abnormal hemoglobin genes in the pathogenesis of fetal growth restriction. These findings highlight the importance of early screening and genetic evaluation in neonates with IUGR to improve diagnosis and long-term outcomes.
The study was conducted in accordance with the principles of the Declaration of Helsinki. The informed consent was obtained from patients.
The authors declare no conflict of interest.
Keywords: intrauterine growth restriction, hemoglobinopathy, newborn, thalassemia, sickle cell disease, fetal hemoglobin.

REFERENCES

1. Al-Allawi N, Al Allawi S, Jalal SD. (2021, Jan). Genetic epidemiology of hemoglobinopathies among Iraqi Kurds. J Community Genet. 12(1): 5-14. Epub 2020 Nov 22. https://doi.org/10.1007/s12687-020-00495-z; PMid:33222097 PMCid:PMC7846650

2. Aliyeva G, Asadov C, Mammadova T, Gafarova S, Guliyeva Y, Abdulalimov E. (2020, May). Molecular and geographical heterogeneity of hemoglobinopathy mutations in Azerbaijanian populations. Ann Hum Genet. 84(3): 249-258. Epub 2019 Nov 21. https://doi.org/10.1111/ahg.12367; PMid:31755088

3. Balayla J, Desilets J, Shrem G. (2019, Aug 27). Placenta previa and the risk of intrauterine growth restriction (IUGR): a systematic review and meta-analysis. J Perinat Med. 47(6): 577-584. https://doi.org/10.1515/jpm-2019-0116; PMid:31301678

4. Blankenhorn K, Strumph K. (2024, Nov 1). Hemoglobinopathies in the Neonate. Neoreviews. 25(11): e720-e728. https://doi.org/10.1542/neo.25-11-e720; PMid:39482242

5. Colah RB, Seth T. (2022, Jan). Thalassemia in India. Hemoglobin. 46(1): 20-26. https://doi.org/10.1080/03630269.2021.2008958; PMid:35950587

6. Fan D, Lin D, Rao J, Li P, Chen G, Zhou Z et al. (2024, Jan 19). Factors and outcomes for placental anomalies: An umbrella review of systematic reviews and meta-analyses. J Glob Health. 14: 04013. https://doi.org/10.7189/jogh.14.04013; PMid:38236697 PMCid:PMC10795857

7. Hassan MK, Abbas RA, Hassan RA, Taghlubee IM, Abd Al Majeed SS et al. (2025, Jan). Prevalence and Spectrum of β-Thalassemia Mutations in Baghdad, Iraq: Data from the Premarital Screening Program. Hemoglobin. 49(1): 31-37. Epub 2025 Jan 7. https://doi.org/10.1080/03630269.2024.2446360; PMid:39773203

8. Jayalakshmi R, Gaidhane S, Ballal S, Kumar S, Bhat M, Sharma S et al. (2025, Jul). The Effect of Maternal Haemoglobinopathies and Iron Deficiency Anaemia on Foetal Growth Restriction: A Systematic Review and Meta-Analysis. Matern Child Nutr. 21(3): e13787. Epub 2025 Apr 15. https://doi.org/10.1111/mcn.13787; PMid:40235159 PMCid:PMC12150161

9. Mammadova T, Asadov C, Alimirzoyeva Z, Abdulalimov E, Aliyeva G. (2024, Sep). Update on Prevention of Hemoglobinopathies in Azerbaijan. Hemoglobin. 48(5): 353-356. Epub 2024 Nov 10. https://doi.org/10.1080/03630269.2024.2427189; PMid:39523367

10. Reibel NJ, Dame C, Bührer C, Muehlbacher T. (2021, Nov 12). Aberrant Hematopoiesis and Morbidity in Extremely Preterm Infants With Intrauterine Growth Restriction. Front Pediatr. 9: 728607. https://doi.org/10.3389/fped.2021.728607; PMid:34869097 PMCid:PMC8633541

11. Therrell BL. (2025, Sep). Newborn Screening for Hemoglobin Disorders. Clin Perinatol. 52(3): 461-476. Epub 2025 Jul 16. https://doi.org/10.1016/j.clp.2025.06.007; PMid:40850710

12. Therrell BL Jr. (2026). Newborn Screening for Hemoglobinopathies and Thalassemias: Brief History, Recent Activities, and Global Status-2026. Int J Neonatal Screen. 12(1): 8. https://doi.org/10.3390/ijns12010008; PMid:41718422 PMCid:PMC12922127