One Less Painful Procedure: Using Umbilical Cord Blood as Alternative Source to Admission Complete Blood Count

2017 ◽  
Vol 34 (12) ◽  
pp. 1178-1184 ◽  
Author(s):  
Neera Prakash ◽  
Joseph Decristofaro ◽  
Echezona Maduekwe

Objective This study aims to evaluate the use of umbilical cord blood as an alternative to the admission complete blood count (CBC) in the well-appearing late preterm neonates admitted to the neonatal intensive care unit. Study Design Paired umbilical cord and admission blood CBC samples from well late preterm infants were compared using a two-sample t-test or analysis of variance with an unequal variance for differences in the hemoglobin, platelet counts, white blood cell, and absolute neutrophil counts. Results A total of 100 infants were enrolled in the study. The study included 46 females, 5 Asian, 9 Black, 35 Hispanic, 51 White, with a mean gestational age of 35.3 ± 1 weeks (range: 34–36.5 weeks), and a mean birth weight of 2,347 ± 491 g (range: 1,840–4,260 g). Around 80% were appropriate for gestational age, 5% were large for gestational age, and 15% were small for gestational age. The median difference between the cord and admission blood samples were hemoglobin: 1.1 g/dL, platelet: 7.50 × 103 cells/μL, white blood cell count: 2.3 × 103 cells/μL, and absolute neutrophil count: 0.6 × 103 cells/μL. Conclusion The cord and admission blood testing were not statistically or clinically different when compared. In well late preterm infants, the NICU admission blood CBC may be replaced with an umbilical cord blood CBC.

2016 ◽  
Vol 36 (2) ◽  
pp. 160-164 ◽  
Author(s):  
Sahisnuta Basnet ◽  
Sandip Kumar Singh ◽  
Brijesh Sathian ◽  
Rajnish Mishra

Correction: Due to an error in loading the metadata, the author Sahisnuta Basnet was omitted. Sahisnuta Basnet was therefore added to the metadata on 9th January 2017. The PDF was correct.Introduction: Reference hematological values in newborns are informative in evaluation of newborns to determine state of health or disease. For a given population, reference values may differ in accordance with various factors such as age, sex, race, diet, drug intake, altitude, socio-economic status and also the method employed for determination of the values. The aim of this study was to establish reference ranges of complete blood count using umbilical cord blood of normal, healthy, full term neonates born in Manipal Teaching Hospital (MTH), Pokhara, Nepal.Material and Method: The study was conducted in 210 full term, healthy newborns delivered in MTH between Jan 2014 to Feb 2015. Cord blood was collected and a complete blood count was obtained using an automated hematology analyzer.Result: Mean hemoglobin was 15.24 ± 1.96 gm/dl and mean red blood cell count was 4.30 ± 0.63 (range 3.05 – 6.36) X 1012/L. Mean white blood cell count was 14.93 ± 4.44 (range 6.10 ± 31.7) X 109/L and platelet count was 226.88 ± 61.28 (range 105 ± 392) X 109/L. There was no significant difference found in hemoglobin, red cell, white cell and platelet counts between males and females in this study.Conclusion: The values obtained from our study provide ranges for some hematological values in healthy newborns of Pokhara Nepal. However, the hematological reference values for Nepalese cord blood needs to be confirmed by larger numbers of samples from different centers of Nepal.J Nepal Paediatr Soc 2016;36(2):160-164.


2019 ◽  
Author(s):  
En-Fu Tao ◽  
Cai-E Chen ◽  
Yun-Qin Chen ◽  
Lin-Yan Cai ◽  
Tian-Ming Yuan

Abstract Background: Low Vitamin A levels of plasma increase the risk of neonates’ morbidity. However, whether umbilical cord blood (UCB) vitamin A levels have an association with the outcomes of late-preterm infants (LPI) is not well established. This study aimed to determine umbilical cord blood vitamin A levels and their correlation with outcomes of late-preterm infants. Methods: We prospectively studied 208 LPI between January 1, 2014,and June 30, 2015. The specimens of UCB were collected shortly after birth, and vitamin A levels were determined by Enzyme-Linked Immunosorbent Assay. All singleton newborns, with 34+0 weeks to 36+6 weeks’ gestational age, were eligible for study inclusion in the studied time intervals. Exclusion criteria included significant congenital malformations or chromosomal abnormality or congenital metabolic disease, or life-threatening disease. All subjects were implemented to follow up, and jaundice, sepsis, respiratory distress syndrome, bronchopulmonary dysplasia, necrotizing enterocolitis, death, etc. were recorded. Results: The prevalence of low UCB vitamin A level <0.7 μmol/L was 37.5% in LPI. UCB vitamin A levels of LPI with cesarean section was lower than that with vaginal delivery (0.734 (0.634-0.796) μmol/L VS 0.904 (0.666-1.100) μmol/L P = 0.001). Additionally, binary logistic regression analysis revealed that the cesarean section was an independent risk factor for UCB vitamin A level < 0.7 μmol/L. However, UCB vitamin A levels did not correlate with gestational age, birth weight, and sex. Neonates with hospitalization or oxygen supplementation or RDS group had significantly lower UCB vitamin A levels than their counterparties ( P < 0.05), other than with hyperbilirubinemia or sepsis ( P > 0.05). However, univariate binary logistics regression analysis suggested that UCB vitamin A level < 0.7 μmol/L was not an independent risk factor for hospitalization, oxygen therapy, hyperbilirubinemia, sepsis and RDS. Conclusions: Low umbilical cord blood vitamin A levels are common among late-preterm infants. Delivery with cesarean section is an independent risk factor for low umbilical cord blood vitamin A level. However, there is no evidence that low vitamin A level is associated with morbidity of late-preterm infants, including hyperbilirubinemia, sepsis and respiratory distress syndrome.


2013 ◽  
Vol 225 (02) ◽  
pp. 70-74 ◽  
Author(s):  
U. Lindner ◽  
E. Tutdibi ◽  
S. Binot ◽  
D. Monz ◽  
A. Hilgendorff ◽  
...  

2021 ◽  
Author(s):  
Gemma Sullivan ◽  
Paola Galdi ◽  
Nis Borbye-Lorenzen ◽  
David Q Stoye ◽  
Gillian J Lamb ◽  
...  

Abstract Objective. To characterise the umbilical cord blood immune profile in preterm infants compared to term-born controls and the postnatal immune response following exposure to histologic chorioamnionitis (HCA) in preterm infants. Design. Descriptive, observational cohort study. Setting. Edinburgh, UK. Population. 118 preterm infants (mean gestational age 29+0 weeks, range 23+2 to 32+0) and 59 term-born controls. Methods. Placental histopathology was used to identify reaction patterns indicative of HCA, and a customised immunoassay of 24 inflammatory markers and trophic proteins selected to reflect the perinatal immune response was performed on umbilical cord blood in term and preterm participants and postnatal day 5 blood in the preterm group. Results. The umbilical cord blood immune profile classified gestational age category with 86% accuracy (95% CI 0.78-0.92), p-value=1.242x10-14. Pro-inflammatory proteins IL-6, MCP-1 and CRP were elevated in the cord blood of preterm infants whilst BDNF, C3, C9, IL-18, MMP-9 and RANTES were decreased, compared to infants born at term. In preterm infants, exposure to HCA was associated with elevations in 5 immune proteins on postnatal day 5 (BDNF, C3, IL-8, MIP-1β and MMP-9) when compared to preterm infants who were not exposed. Conclusion. Preterm birth is associated with a distinct immune profile in umbilical cord blood and infants exposed to HCA experience specific alterations in immune function that persist to day 5 of postnatal life.


2021 ◽  
Vol 12 ◽  
Author(s):  
Luyan Han ◽  
Bo Li ◽  
Xiaojing Xu ◽  
Shufang Liu ◽  
Zhenghong Li ◽  
...  

BackgroundPremature/low-birth-weight infants are at significant risk of metabolic diseases in adulthood, which may be related to the levels of fetal adipokine. Here, we investigated the differences in the levels of umbilical cord blood adiponectin, leptin, insulin, and ghrelin in preterm and term infants and sought to elucidate the link between these hormones and fetal growth. We also evaluated the interrelationship among these metabolic hormones in both groups of newborns.MethodsA total of 149 mother–infant pairs (100 in the preterm group and 49 in the term group) were enrolled in the study. The preterm group was further subdivided according to birth weight (≤1,500, 1,501–2,000, 2,001–2,500, and &gt;2,500 g), gestational age (&lt;34 vs. ≥34 weeks), and appropriate for gestational age (AGA) vs. small for gestational age (SGA). The general condition of the mothers and the growth parameters of the newborns at birth were recorded.ResultsThe levels of adiponectin, leptin, and ghrelin were lower in the preterm group than those in the term group (p &lt; 0.05). In the preterm group, the leptin levels of infants with gestational age ≥34 weeks were significantly higher than those of infants with gestational age &lt;34 weeks (mean ln leptin = 0.63 vs. 0.36 ng/ml, p = 0.009). The levels of adiponectin were lower in the SGA group than those in the AGA group (mean ln adiponectin = 2.26 vs. 2.84 µg/ml, p = 0.001), whereas those of ghrelin displayed the opposite trend (mean ln ghrelin = 6.29 vs. 5.71 pg/ml, p &lt; 0.001). Leptin was significantly correlated with insulin both in preterm infants with birth weight (BW) &gt;2,000 g and in term infants. Umbilical cord blood leptin was positively correlated with the BW, birth length, and head circumference of newborns (r = 0.460, 0.311, and 0.310, respectively, all p &lt; 0.05), whereas ghrelin was negatively correlated with the same parameters (r = −0.372, −0.415, and −0.373, respectively, all p &gt; 0.05).ConclusionsThe lack of maturation of adipose tissue and the gastrointestinal tract by the fetus due to prematurity is associated with changes in the levels of cord blood adiponectin, leptin, and ghrelin. The dysregulation of these hormones in preterm infants may be a risk factor for fetal growth and future metabolic diseases.


2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Mehmet Gündüz ◽  
Hayrettin Temel

Background and Objective: Umbilical cord blood which can be obtained by a non-invasive method can be informative about the clinical status of the newborn. It was aimed to establish reference intervals for umbilical cord blood parameters, and to compare complete blood count results between umbilical cord and venous blood samples in this study. Methods: This study was conducted at Medipol University Sefaköy Hospital, Department of Pediatrics, Istanbul, Turkey. A total of 1898 newborns who were born in a two-year period between January 2018 and December 2019 were included in the study. Venous blood samples were taken from 184 of them, and umbilical cord blood samples were taken from 1714 newborns. Results: The percentiles were determined according to gender and delivery method for the hematological parameters of umbilical cord blood. While mean platelet, eosinophil and mean corpuscular volume values ​​were similar between the groups (p>0.05 for each), and significant differences were found between the groups in terms of all other mean hematological parameters ​​(p<0.05 for each). Conclusion: The results of the complete blood count of umbilical cord blood samples can provide reliable information about the newborn. There are significant differences between umbilical cord and venous blood samples in terms of hematological parameters. For these reasons, it is necessary to determine reliable value ranges for umbilical cord blood hematological parameters in newborns. Data of our study can be a guide for further studies and clinicians. doi: https://doi.org/10.12669/pjms.37.2.2526 How to cite this:Gunduz M, Temel H. Reference intervals for complete blood count from Umbilical Cord Blood in newborns and comparison with Venous Blood Values. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.2526 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 12 ◽  
Author(s):  
Gemma Sullivan ◽  
Paola Galdi ◽  
Nis Borbye-Lorenzen ◽  
David Q. Stoye ◽  
Gillian J. Lamb ◽  
...  

IntroductionPreterm infants are at increased risk of exposure to histologic chorioamnionitis (HCA) when compared to term-born controls, and this is associated with several neonatal morbidities involving brain, lungs and gut. Preterm infants could benefit from immunomodulatory therapies in the perinatal period, but development of rational treatment strategies requires improved characterization of the perinatal response to HCA. We had two objectives: The first, to characterize the umbilical cord blood immune profile in preterm infants compared to term-born controls; the second, to investigate the postnatal immune response in preterm infants exposed to HCA versus those who were not.PopulationFor objective one 59 term infants [mean gestational age (GA) 39+4 (37+3 to 42+0)] and 55 preterm infants [mean GA29+0(23+3 to 32+0)] with umbilical cord samples available were included; for objective two we studied 96 preterm infants [mean GA29+1(23+2 to 32+0)] for whom placental histology and postnatal blood samples were available.MethodsPlacental histopathology was used to identify reaction patterns indicative of HCA, and a customized immunoassay of 24 inflammatory markers and trophic proteins selected to reflect the perinatal immune response was performed on umbilical cord blood in term and preterm participants and postnatal day 5 blood in the preterm group.ResultsThe umbilical cord blood immune profile classified gestational age category with 86% accuracy (95% CI 0.78-0.92), p-value=1.242x10-14. Pro-inflammatory proteins IL-6, MCP-1 and CRP were elevated in the cord blood of preterm infants whilst BDNF, C3, C9, IL-18, MMP-9 and RANTES were decreased, compared to infants born at term. In preterm infants, exposure to HCA was associated with elevations in 8 immune proteins on postnatal day 5 (BDNF, C3, C5a, C9, IL-8, MCP-1, MIP-1β and MMP-9) when compared to preterm infants who were not exposed.ConclusionPreterm birth is associated with a distinct immune profile in umbilical cord blood and preterm infants exposed to HCA with evidence of a fetal inflammatory response have specific alterations in immune function that are apparent on day 5 of postnatal life.


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