Home Capillary blood parameters are gestational age, birthweight, delivery mode and gender dependent in healthy preterm and term infants
Article
Licensed
Unlicensed Requires Authentication

Capillary blood parameters are gestational age, birthweight, delivery mode and gender dependent in healthy preterm and term infants

  • Marika Perrotta , Ebe D’Adamo , Chiara Strozzi , Claudia D’Egidio , Francesca Del Rosso , Antonio Maconi , Simonetta Picone , Giustina Giardinelli , Laura Cepelli , Ilenia Cicolini , Mariangela Conte , Mariangela Bellinaso , Rossana Negri , Francesca Gazzolo , Maurizio Cassinari , Laura Abella , Ali Saber Abdelhameed , Rocco Mangifesta and Diego Gazzolo EMAIL logo
Published/Copyright: August 23, 2024
Become an author with De Gruyter Brill
Submit Manuscript Author Information
Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 63 Issue 1

Abstract

Objectives

The measurement of blood pH and gas analytes (BPGA), soon after birth, constitutes the first-line standard of care procedure in high-risk newborns. However, no data is available in capillary blood on perinatal bias such as gestational age (GA), weight at birth (BW), delivery mode, and gender. The aims of the present study were to investigate whether in a cohort of healthy preterm (PT) and term (T) infants BPGA were GA, BW, delivery mode and gender dependent, thus affecting BPGA reliability as diagnostic test.

Methods

We performed a prospective case-control study in 560 healthy infants (PT: n=115, T: n=445). BPGA was measured within 24-h from birth. Perinatal characteristics, outcomes, and clinical examination were also recorded.

Results

PT infants showed higher (p<0.001) carbon dioxide partial pressure (pCO2), fraction of fetal hemoglobin (HbF), base excess (BE), bicarbonate (HCO3), and lower lactate (Lac) levels. When corrected for delivery mode, higher (p<0.001) HbF, BE, HCO3, and lower Lac levels were found. Similarly, higher (p<0.05, for all) pCO2, HbF, BE, HCO3 and lower Lac levels were found between female and male PT and T infants. Repeated multiple logistic regression analysis showed that BPGA was GA, BW, delivery mode and gender dependent.

Conclusions

The present results showing that BPGA can be affected by a series of perinatal outcomes open the way to further investigations providing longitudinal BPGA reference curves in the transitional phase, thus empowering BPGA role as a reliable diagnostic and therapeutic strategies efficacy marker.

Keywords: perinatal asphyxia; prematurity; blood pH; delivery mode; gender
Corresponding author: Prof. Diego Gazzolo, Neonatal Intensive Care Unit G d’Annunzio University of Chieti, 65100 Chieti, Italy, E-mail:

  1. Research ethics: The local Ethic Committees of the Cooperative Multitask against Brain Injury of Neonates (CoMBINe) International Network approved the study protocol.

  2. Informed consent: Informed consent was obtained from all the individuals included in this study, or from their legal guardians or wards.

  3. Author contributions: MP, ED’A, CS, CD’E, FDR, AM, SP, GG, LC, IC, MC, MB, RN, FG, MC, LA, ASA, RM contributed to the conceptualization, investigation and writing of the original draft. D.G. contributed to the project administration, conceptualization, investigation, supervision and writing, review and editing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission. All authors have read and agreed to the published version of the manuscript.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: This work is part of the I.O. PhD International Program under the auspices of the Italian Society of Neonatology and was partially supported by grants to DG from “I Colori della Vita Foundation”, Italy. The authors extend their sincere appreciation to Researchers Supporting Project number (RSPD2024R750), King Saud University, Riyadh, Saudi Arabia. The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report or in the decision to submit the report for publication.

  6. Data availability: Not applicable.

References

1. Morton, SU, Brodsky, D. Fetal physiology and the transition to extrauterine life. Clin Perinatol 2016;43:395–407. https://doi.org/10.1016/j.clp.2016.04.001.Search in Google Scholar PubMed PubMed Central

2. Hillman, NH, Kallapur, SG, Jobe, AH. Physiology of transition from intrauterine to extrauterine life. Clin Perinatol 2012;39:769–83. https://doi.org/10.1016/j.clp.2012.09.009.Search in Google Scholar PubMed PubMed Central

3. Baik-Schneditz, N, Schwaberger, B, Urlesberger, B, Wolfsberger, CH, Bruckner, M, Pichler, G. Acid base and blood gas analysis in term neonates immediately after birth with uncomplicated neonatal transition. BMC Pediatr 2022;22:271–8. https://doi.org/10.1186/s12887-022-03324-z.Search in Google Scholar PubMed PubMed Central

4. Bockholt, R, Paschke, S, Heubner, L, Ibarlucea, B, Laupp, A, Janićijević, Ž, et al.. Real-time monitoring of blood parameters in the intensive care unit: state-of-the-art and perspectives. J Clin Med 2022;11:2408–16. https://doi.org/10.3390/jcm11092408.Search in Google Scholar PubMed PubMed Central

5. Josephsen, JB, Strand, ML. Providing ventilation to the newborn infant in the delivery room. NeoReviews 2017;18:658–64. https://doi.org/10.1542/neo.18-11-e658.Search in Google Scholar

6. Rainaldi, MA, Perlman, JM. Pathophysiology of birth asphyxia. Clin Perinatol 2016;43:409–22. https://doi.org/10.1016/j.clp.2016.04.002.Search in Google Scholar PubMed

7. Ng, EH, Shah, V. Guidelines for surfactant replacement therapy in neonates. Paediatr Child Health 2021;26:35–49. https://doi.org/10.1093/pch/pxaa116.Search in Google Scholar PubMed PubMed Central

8. Walas, W, Wilińska, M, Bekiesińska-Figatowska, M, Halaba, Z, Śmigiel, R. Methods for assessing the severity of perinatal asphyxia and early prognostic tools in neonates with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia. Adv Clin Exp Med 2020;29:1011–6. https://doi.org/10.17219/acem/124437.Search in Google Scholar PubMed

9. Sakpichaisakul, K, Supapannachart, KJ, El-Dib, M, Szakmar, E, Yang, E, Walsh, BH, et al.. Blood gas measures as predictors for neonatal encephalopathy severity. J Perinatol 2021;41:2261–9. https://doi.org/10.1038/s41372-021-01075-w.Search in Google Scholar PubMed

10. Brodkorb, S, Sidorenko, I, Turova, V, Rieger-Fackeldey, E, Felderhoff-Müser, U, Kovtanyuk, A, et al.. Accounting for arterial and capillary blood gases for calculation of cerebral blood flow in preterm infants. Eur J Pediatr 2022;181:2087–96. https://doi.org/10.1007/s00431-022-04392-0.Search in Google Scholar PubMed PubMed Central

11. Perretta, JS. Neonatal and pediatric respiratory care, 10th ed.. United States F.A.: Davis Company; 2014.Search in Google Scholar

12. Evans, DL, Volsko, TA, Capellari, E, Strickland, SL. AARC Clinical Practice Guidelines: capillary blood gas sampling for neonatal and pediatric patients. Respir Care 2022;67:1190–204. https://doi.org/10.4187/respcare.10151.Search in Google Scholar PubMed

13. WHO. Guidelines on drawing blood: best practices in phlebotomy. Geneva: World Health Organization; 2010. PMID: 23741774.Search in Google Scholar

14. Fan, I, Hiersch, L, Belov, Y, Amikam, U, Tzur, Y, Hershkovitz, G, et al.. The effects of time and temperature on umbilical cord gas analysis. J Matern Fetal Neonatal Med 2022;35:4358–64. https://doi.org/10.1080/14767058.2020.1849118.Search in Google Scholar PubMed

15. Olofsson, P. Umbilical cord pH, blood gases, and lactate at birth: normal values, interpretation, and clinical utility. Am J Obstet Gynecol 2023;228:1222–40. https://doi.org/10.1016/j.ajog.2022.07.001.Search in Google Scholar PubMed

16. Campbell, S, Thoms, A. Ultrasound measurement of the fetal head to abdomen circumference ratio in the assessment of growth retardation. Br J Obstet Gynecol 2000;182:650–4.Search in Google Scholar

17. Villar, J, Cheikh Ismail, L, Victora, CG, Ohuma, EO, Bertino, E, Altman, DG, et al.. International standards for newborn weight, length, and head circumference by gestational age and sex: the Newborn Cross-Sectional Study of the INTERGROWTH-21st Project. Lancet 2014;384:857–68. https://doi.org/10.1016/s0140-6736(14)60932-6.Search in Google Scholar PubMed

18. Prechtl, HFR. Assessment methods for the newborn infant: a critical evaluation. In: Stratton, D, editor. Psychobiology of the Human Newborn, 3rd ed. Chichester, UK: Wiley; 1982:21–52 pp.Search in Google Scholar

19. Jurgens-van der Zee, AD, Bierman-van Eendenburg, ME, Fidler, VJ, Olinga, AA, Visch, JH, Touwen, BC, et al.. Preterm birth, growth retardation and acidemia in relation to neurological abnormality of the newborn. Early Hum Dev 1979;3:141–54. https://doi.org/10.1016/0378-3782(79)90003-3.Search in Google Scholar PubMed

20. Ohuma, EO, Moller, AB, Bradley, E, Chakwera, S, Hussain-Alkhateeb, L, Lewin, A, et al.. National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis. Lancet 2023;402:1261–71. https://doi.org/10.1016/s0140-6736(23)00878-4.Search in Google Scholar PubMed

21. Simon, NT, Hagan, PM, Rockhill, KM, Heyborne, KD. Changes in metabolic acidosis following birth in intensive care unit neonates. Eur J Obstet Gynecol Reprod Biol 2024;297:161–8. https://doi.org/10.1016/j.ejogrb.2024.04.025.Search in Google Scholar PubMed

22. Leviton, A, Allred, E, Kuban, KC, Dammann, O, O’Shea, TM, Hirtz, D, et al.. Early blood gas abnormalities and the preterm brain. Am J Epidemiol 2010;172:907–16. https://doi.org/10.1093/aje/kwq222.Search in Google Scholar PubMed PubMed Central

23. Cousineau, J, Anctil, S, Carceller, A, Gonthier, M, Delvin, EE. Neonate capillary blood gas reference values. Clin Biochem 2005;38:905–7. https://doi.org/10.1016/j.clinbiochem.2005.07.006.Search in Google Scholar PubMed

24. Eshraghi, N, Karandish, H, Mazouri, A, Abdi, A, Kashaki, M, Bordbar, A. Comparative analysis of neonatal umbilical cord blood gases across various delivery modes at a referral center. Arch Gynecol Obstet 2024. https://doi.org/10.1007/s00404-024-07594-z.Search in Google Scholar PubMed

25. Zaigham, M, Helfer, S, Kristensen, KH, Isberg, PE, Wiberg, N. Maternal arterial blood gas values during delivery: effect of mode of delivery, maternal characteristics, obstetric interventions and correlation to fetal umbilical cord blood. Acta Obstet Gynecol Scand 2020;99:1674–81. https://doi.org/10.1111/aogs.13936.Search in Google Scholar PubMed

26. Montero-Salinas, A, Pérez-Ramos, M, Toba-Alonso, F, Quintana-DelRío, L, Suanzes-Hernández, J, Sobrido-Prieto, M, et al.. Analysis of arterial blood gas values based on storage time since sampling: an observational study. Nurs Rep 2021;11:517–21. https://doi.org/10.3390/nursrep11030048.Search in Google Scholar PubMed PubMed Central

27. Schittny, JC. Development of the lung. Cell Tissue Res 2017;367:427–44. https://doi.org/10.1007/s00441-016-2545-0.Search in Google Scholar PubMed PubMed Central

28. MacDonald, MG, Seshia, MRK. Avery’s Neonatology: pathophysiology and management of the newborn, 7th ed. Philadelphia: Wolters Kluwer; 2016:372–94 pp.Search in Google Scholar

29. Darnall, RA. The role of CO(2) and central chemoreception in the control of breathing in the fetus and the neonate. Respir Physiol Neurobiol 2010;173:201–12. https://doi.org/10.1016/j.resp.2010.04.009.Search in Google Scholar PubMed PubMed Central

30. Hoffman, SB, Lakhani, A, Viscardi, RM. The association between carbon dioxide, cerebral blood flow, and autoregulation in the premature infant. J Perinatol 2021;41:324–9. https://doi.org/10.1038/s41372-020-00835-4.Search in Google Scholar PubMed PubMed Central

31. Dana, M, Fibach, E. Fetal hemoglobin in the maternal circulation - contribution of fetal red blood cells. Hemoglobin 2018;42:138–40. https://doi.org/10.1080/03630269.2018.1466712.Search in Google Scholar PubMed

32. Jain, L, Dudell, GG. Respiratory transition in infants delivered by cesarean section. Semin Perinatol 2006;30:296–304. https://doi.org/10.1053/j.semperi.2006.07.011.Search in Google Scholar PubMed

33. Mönkkönen, A, Rajala, K, Backman, H, Keski-Nisula, L. Umbilical arterial lactate levels after normal vaginal and elective cesarean delivery: the role of a longer active second stage most significant in high levels after vaginal delivery. J Obstet Gynaecol Res 2024;50:557–65. https://doi.org/10.1111/jog.15875.Search in Google Scholar PubMed

34. Noh, EJ, Kim, YH, Cho, MK, Kim, JW, Kim, JW, Byun, YJ, et al.. Comparison of oxidative stress markers in umbilical cord blood after vaginal and cesarean delivery. Obstet Gynecol Sci 2014;57:109–14. https://doi.org/10.5468/ogs.2014.57.2.109.Search in Google Scholar PubMed PubMed Central

35. Contag, SA, Clifton, RG, Bloom, SL, Spong, CY, Varner, MW, Rouse, DJ, et al.. Neonatal outcomes and operative vaginal delivery versus cesarean delivery. Am J Perinatol 2010;27:493–9. https://doi.org/10.1055/s-0030-1247605.Search in Google Scholar PubMed PubMed Central

36. Serpero, LD, Bianchi, V, Pluchinotta, F, Conforti, E, Baryshnikova, E, Guaschino, R, et al.. S100B maternal blood levels are gestational age- and gender-dependent in healthy pregnancies. Clin Chem Lab Med 2017;55:1770–6. https://doi.org/10.1515/cclm-2016-1127.Search in Google Scholar PubMed

37. Picone, S, Ritieni, A, Fabiano, A, Troise, AD, Graziani, G, Paolillo, P, et al.. Arterial cord blood lutein levels in preterm and term healthy newborns are sex and gestational age dependent. Clin Biochem 2012;45:1558–63. https://doi.org/10.1016/j.clinbiochem.2012.07.109.Search in Google Scholar PubMed

38. Kostro, M, Jacyna, N, Głuszczak-Idziakowska, E, Sułek-Kamas, K, Jakiel, G, Wilińska, M. Factors affecting the differentiation of the apgar score and the biochemical correlation of fetal well-being – a prospective observational clinical study. J Mother Child 2021;22:238–46. https://doi.org/10.34763/devperiodmed.20182203.238246.Search in Google Scholar PubMed PubMed Central

Received: 2024-07-17
Accepted: 2024-08-14
Published Online: 2024-08-23
Published in Print: 2025-01-29

© 2024 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Blood self-sampling: friend or foe?
  4. Reviews
  5. Blood self-sampling devices: innovation, interpretation and implementation in total lab automation
  6. Salivary fatty acids in humans: a comprehensive literature review
  7. Opinion Papers
  8. EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
  9. Point-of-care testing: state-of-the art and perspectives
  10. A standard to report biological variation data studies – based on an expert opinion
  11. Ethical Checklists for Clinical Research Projects and Laboratory Medicine: two tools to evaluate compliance with bioethical principles in different settings
  12. Guidelines and Recommendations
  13. Assessment of cardiovascular risk and physical activity: the role of cardiac-specific biomarkers in the general population and athletes
  14. Genetics and Molecular Diagnostics
  15. Clinical utility of regions of homozygosity (ROH) identified in exome sequencing: when to pursue confirmatory uniparental disomy testing for imprinting disorders?
  16. An ultrasensitive DNA-enhanced amplification method for detecting cfDNA drug-resistant mutations in non-small cell lung cancer with selective FEN-assisted degradation of dominant somatic fragments
  17. General Clinical Chemistry and Laboratory Medicine
  18. The biological variation of insulin resistance markers: data from the European Biological Variation Study (EuBIVAS)
  19. The surveys on quality indicators for the total testing process in clinical laboratories of Fujian Province in China from 2018 to 2023
  20. Preservation of urine specimens for metabolic evaluation of recurrent urinary stone formers
  21. Performance evaluation of a smartphone-based home test for fecal calprotection
  22. Implications of monoclonal gammopathy and isoelectric focusing pattern 5 on the free light chain kappa diagnostics in cerebrospinal fluid
  23. Development and validation of a novel 7α-hydroxy-4-cholesten-3-one (C4) liquid chromatography tandem mass spectrometry method and its utility to assess pre-analytical stability
  24. Establishment of ELISA-comparable moderate and high thresholds for anticardiolipin and anti-β2 glycoprotein I chemiluminescent immunoassays according to the 2023 ACR/EULAR APS classification criteria and evaluation of their diagnostic performance
  25. Reference Values and Biological Variations
  26. Capillary blood parameters are gestational age, birthweight, delivery mode and gender dependent in healthy preterm and term infants
  27. Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents
  28. Cancer Diagnostics
  29. Detection of serum CC16 by a rapid and ultrasensitive magnetic chemiluminescence immunoassay for lung disease diagnosis
  30. Cardiovascular Diseases
  31. The role of functional vitamin D deficiency and low vitamin D reservoirs in relation to cardiovascular health and mortality
  32. Annual Reviewer Acknowledgment
  33. Reviewer Acknowledgment
  34. Letters to the Editor
  35. EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) survey on cybersecurity
  36. Comment on Lippi et al.: EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
  37. Six Sigma in laboratory medicine: the unfinished symphony
  38. Navigating complexities in vitamin D and cardiovascular health: a call for comprehensive analysis
  39. Simplified preanalytical laboratory procedures for therapeutic drug monitoring (TDM) in patients treated with high-dose methotrexate (HD-MTX) and glucarpidase
  40. New generation of Abbott enzyme assays: imprecision, methods comparison, and impact on patients’ results
  41. Correction of negative-interference from calcium dobesilate in the Roche sarcosine oxidase creatinine assay using CuO
  42. Two cases of MTHFR C677T polymorphism typing failure by Taqman system due to MTHFR 679 GA heterozygous mutation
  43. A falsely elevated blood alcohol concentration (BAC) related to an intravenous administration of phenytoin sodium
https://doi.org/10.1515/cclm-2024-0821
Keywords for this article
perinatal asphyxia; prematurity; blood pH; delivery mode; gender

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Blood self-sampling: friend or foe?
  4. Reviews
  5. Blood self-sampling devices: innovation, interpretation and implementation in total lab automation
  6. Salivary fatty acids in humans: a comprehensive literature review
  7. Opinion Papers
  8. EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
  9. Point-of-care testing: state-of-the art and perspectives
  10. A standard to report biological variation data studies – based on an expert opinion
  11. Ethical Checklists for Clinical Research Projects and Laboratory Medicine: two tools to evaluate compliance with bioethical principles in different settings
  12. Guidelines and Recommendations
  13. Assessment of cardiovascular risk and physical activity: the role of cardiac-specific biomarkers in the general population and athletes
  14. Genetics and Molecular Diagnostics
  15. Clinical utility of regions of homozygosity (ROH) identified in exome sequencing: when to pursue confirmatory uniparental disomy testing for imprinting disorders?
  16. An ultrasensitive DNA-enhanced amplification method for detecting cfDNA drug-resistant mutations in non-small cell lung cancer with selective FEN-assisted degradation of dominant somatic fragments
  17. General Clinical Chemistry and Laboratory Medicine
  18. The biological variation of insulin resistance markers: data from the European Biological Variation Study (EuBIVAS)
  19. The surveys on quality indicators for the total testing process in clinical laboratories of Fujian Province in China from 2018 to 2023
  20. Preservation of urine specimens for metabolic evaluation of recurrent urinary stone formers
  21. Performance evaluation of a smartphone-based home test for fecal calprotection
  22. Implications of monoclonal gammopathy and isoelectric focusing pattern 5 on the free light chain kappa diagnostics in cerebrospinal fluid
  23. Development and validation of a novel 7α-hydroxy-4-cholesten-3-one (C4) liquid chromatography tandem mass spectrometry method and its utility to assess pre-analytical stability
  24. Establishment of ELISA-comparable moderate and high thresholds for anticardiolipin and anti-β2 glycoprotein I chemiluminescent immunoassays according to the 2023 ACR/EULAR APS classification criteria and evaluation of their diagnostic performance
  25. Reference Values and Biological Variations
  26. Capillary blood parameters are gestational age, birthweight, delivery mode and gender dependent in healthy preterm and term infants
  27. Reference intervals and percentiles for soluble transferrin receptor and sTfR/log ferritin index in healthy children and adolescents
  28. Cancer Diagnostics
  29. Detection of serum CC16 by a rapid and ultrasensitive magnetic chemiluminescence immunoassay for lung disease diagnosis
  30. Cardiovascular Diseases
  31. The role of functional vitamin D deficiency and low vitamin D reservoirs in relation to cardiovascular health and mortality
  32. Annual Reviewer Acknowledgment
  33. Reviewer Acknowledgment
  34. Letters to the Editor
  35. EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) survey on cybersecurity
  36. Comment on Lippi et al.: EFLM Task Force Preparation of Labs for Emergencies (TF-PLE) recommendations for reinforcing cyber-security and managing cyber-attacks in medical laboratories
  37. Six Sigma in laboratory medicine: the unfinished symphony
  38. Navigating complexities in vitamin D and cardiovascular health: a call for comprehensive analysis
  39. Simplified preanalytical laboratory procedures for therapeutic drug monitoring (TDM) in patients treated with high-dose methotrexate (HD-MTX) and glucarpidase
  40. New generation of Abbott enzyme assays: imprecision, methods comparison, and impact on patients’ results
  41. Correction of negative-interference from calcium dobesilate in the Roche sarcosine oxidase creatinine assay using CuO
  42. Two cases of MTHFR C677T polymorphism typing failure by Taqman system due to MTHFR 679 GA heterozygous mutation
  43. A falsely elevated blood alcohol concentration (BAC) related to an intravenous administration of phenytoin sodium
Sign up now to receive a 20% welcome discount
Institutional Access
How does access work?
Have an idea on how to improve our website?
Please write us.
© 2025 De Gruyter Brill
Downloaded on 26.9.2025 from https://www.degruyterbrill.com/document/doi/10.1515/cclm-2024-0821/html
Scroll to top button