The presence of increased Hb Bart's (gamma 4) in cord blood is believed to be an indication of alpha-thalassemia. We have used restriction endonuclease nalyses of DNA to compare the number of alpha-genes with the percentage of Hb Bart's in 6 older children who had Hb Bart's at birth and 17 newborns. Four children with > 2% Hb Bart's had Eco R1 alpha-gene patterns and hematologic data consistent with the presence of two alpha-genes, one per chromosome. Of the remaining 19 children, all of whom had < 2% Hb Bart's, 8 had 3, while 11 had 4 alpha-genes. Three infants with Hb Bart's between 1% or less Hb Bart's. infants with 3 alpha-genes may therefore have elevated or normal levels of Hb Bart's at birth. DNA analysis is the definitive method for the determination of heterozygous alpha-thalassemia syndromes in newborns.

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