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Red blood cell parameters in early childhood: a prospective cohort study

  • Sofie Taageby Nielsen , Rikke Mohr Lytsen , Nina Strandkjær , Malene Kongsgaard Hansen , Anne-Sophie Sillesen , R. Ottilia B. Vøgg , Anna Axelsson Raja , Ida Juul Rasmussen , Pia R. Kamstrup , Marianne Benn , Kasper Iversen , Henning Bundgaard and Ruth Frikke-Schmidt EMAIL logo
Published/Copyright: November 16, 2022
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Clinical Chemistry and Laboratory Medicine (CCLM)
From the journal Clinical Chemistry and Laboratory Medicine (CCLM) Volume 61 Issue 2

Abstract

Objectives

Red blood cell parameters are frequently used biomarkers when assessing clinical status in newborns and in early childhood. Cell counts, amounts, and concentrations of these parameters change through gestation and after birth. Robust age-specific reference intervals are needed to optimize clinical decision making.

Methods

The Copenhagen Baby Heart Study (CBHS) and the COMPARE study are prospective cohort studies including red blood cell parameters from 7,938 umbilical cord blood samples and 295 parallel venous blood samples from newborns with follow-up at two and at 14–16 months after birth.

Results

For venous blood at birth, reference intervals for hemoglobin, erythrocytes, and hematocrit were 145–224 g/L, 4.1–6.4 × 1012/L, and 0.44–0.64, respectively. Hemoglobin, erythrocytes, and hematocrit were lower at birth in children delivered by prelabor cesarean section compared to vaginal delivery. Conversion algorithms based on term newborns were: venous hemoglobin=(umbilical cord hemoglobin˗86.4)/0.39; venous erythrocytes=(umbilical cord erythrocytes-2.20)/0.44; and venous hematocrit=(umbilical cord hematocrit-0.24)/0.45.

Conclusions

This study presents new reference intervals for red blood cell parameters in early childhood, describes the impact of delivery mode, and provide exact functions for converting umbilical cord to venous blood measurements for term newborns. These findings may improve clinical decision making within neonatology and infancy and enhance our clinical understanding of red blood cell parameters for health and diseases in early life.

Keywords: cord blood; hematology; neonatology; pediatrics; reference intervals
Corresponding author: Ruth Frikke-Schmidt, MD, DMSc, Professor, Chief Physician, Department of Clinical Biochemistry, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; and Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark, Phone: +45 3545 4348, Fax: +45 3545 2880, E-mail:

Funding source: Lundbeckfonden

Funding source: Snedkermester Sophus Jacobsen og Hustru Astrid Jacobsens Fond

Funding source: The Research Council at Herlev-Gentofte Hospital

Funding source: Candy Foundation

Funding source: Hjerteforeningen

Funding source: Research Council at the capital Region of Denmark

Acknowledgments

We thank the staff at the maternity wards at Herlev Hospital, Hvidovre Hospital and Rigshospitalet. We are grateful to the staff and participants of the Copenhagen Baby Heart Study and the COMPARE study for their important contributions to the cohorts.

  1. Research funding: This work was supported by the Research Council at Herlev-Gentofte Hospital, Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond, The Danish Heart Foundation, The Research Council at the capital Region of Denmark, the Candy Foundation, and the Lundbeck Foundation. 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.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: The research related to human use has complied with all relevant national regulations, institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ Institutional Review Board the Regional Ethics Committee of the Capital Region of Denmark (H-16001518), and the Danish Data Protection Agency (I-Suite no.: 04546, ID-no. HGH-2016-53).

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2022-0826).

Received: 2022-08-24
Accepted: 2022-10-29
Published Online: 2022-11-16
Published in Print: 2023-01-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2022-0826
Keywords for this article
cord blood; hematology; neonatology; pediatrics; reference intervals

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. Standardization and harmonization in laboratory medicine: not only for clinical chemistry measurands
  4. Mini Review
  5. The effect of the immunoassay curve fitting routine on bias in troponin
  6. Opinion Papers
  7. An overview of the most important preanalytical factors influencing the clinical performance of SARS-CoV-2 antigen rapid diagnostic tests (Ag-RDTs)
  8. Time to address quality control processes applied to antibody testing for infectious diseases
  9. Perspectives
  10. Definition and application of performance specifications for measurement uncertainty of 23 common laboratory tests: linking theory to daily practice
  11. The gaps between the new EU legislation on in vitro diagnostics and the on-the-ground reality
  12. General Clinical Chemistry and Laboratory Medicine
  13. Second-generation Elecsys cerebrospinal fluid immunoassays aid diagnosis of early Alzheimer’s disease
  14. Evaluation of the interchangeability between the new fully-automated affinity chrome-mediated immunoassay (ACMIA) and the Quantitative Microsphere System (QMS) with a CE-IVD-certified LC-MS/MS assay for therapeutic drug monitoring of everolimus after solid organ transplantation
  15. Quantitative detection of anti-PLA2R antibodies targeting different epitopes and its clinical application in primary membranous nephropathy
  16. Reference Values and Biological Variations
  17. A zlog-based algorithm and tool for plausibility checks of reference intervals
  18. Harmonization of indirect reference intervals calculation by the Bhattacharya method
  19. Red blood cell parameters in early childhood: a prospective cohort study
  20. Cancer Diagnostics
  21. Association of circulating free and total oxysterols in breast cancer patients
  22. Effect of short-term storage of blood samples on gene expression in lung cancer patients
  23. Infectious Diseases
  24. Operation Moonshot: rapid translation of a SARS-CoV-2 targeted peptide immunoaffinity liquid chromatography-tandem mass spectrometry test from research into routine clinical use
  25. Seroprevalence of SARS-CoV-2 antibodies in Italy in newborn dried blood spots
  26. Positivization time of a COVID-19 rapid antigen self-test predicts SARS-CoV-2 viral load: a proof of concept
  27. New insights into SARS-CoV-2 Lumipulse G salivary antigen testing: accuracy, safety and short TAT enhance surveillance
  28. Preanalytical stability of SARS-CoV-2 anti-nucleocapsid antibodies
  29. Prognostic value of procalcitonin in cancer patients with coronavirus disease 2019
  30. 24/7 workflow for bloodstream infection diagnostics in microbiology laboratories: the first step to improve clinical management
  31. Diagnostic performance of machine learning models using cell population data for the detection of sepsis: a comparative study
  32. Diagnostic value of procalcitonin, hypersensitive C-reactive protein and neutrophil-to-lymphocyte ratio for bloodstream infections in pediatric tumor patients
  33. Letters to the Editor
  34. Pseudohyponatremia: interference of hyperglycemia on indirect potentiometry
  35. Ligand binding assay-related underestimation of 25-hydroxyvitamin D in pregnant women exaggerates the prevalence of vitamin D insufficiency
  36. Urokinase-type plasminogen activator soluble receptor (suPAR) assay in clinical routine: evaluation one year after its introduction in the high automation corelab of the A. Gemelli hospital
  37. Is this a true lambda free light chain?
  38. Effect of various blood collection tubes on serum lithium and other electrolytes: our perspective from a tertiary healthcare institute
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