scholarly journals Umbilical cord blood hematological parameters reference interval for newborns from Addis Ababa, Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ammanuel Angelo ◽  
Girma Derbie ◽  
Asrat Demtse ◽  
Aster Tsegaye
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Gestational Age ◽  
Addis Ababa ◽  
Hematological Parameters ◽  
Laboratory Data ◽  
Reference Interval ◽  
Significant Difference ◽  
Non Parametric

Abstract Background Several factors like altitude, age, sex, pregnancy, socioeconomic status, life style and race influence hematological reference interval (RIs), which are critical to support clinical decisions and to interpret laboratory data in research. Currently there are no well-established RIs for cord blood hematological parameters of newborns in Ethiopia. This study aims to generate RIs for umbilical cord blood hematological parameters of newborns from Addis Ababa, Ethiopia. Method A cross-sectional study was conducted from January 1 to March 31, 2019 on healthy, term newborns (37–42 weeks) with normal birth weight born to apparently healthy pregnant mothers who had met the eligibility criteria. From 139 newborns, 2-3ml cord blood was immediately collected from the clumped cord using EDTA tube. The samples were analyzed using Sysmex KX 21 hematology analyzer. Data was entered and the 2.5th and 97.5th percentiles (upper and lower reference limit) were determined using non parametric method by SPSS version 23. The non-parametric independent Mann-Whitney U test (Wilcoxon rank-sum test) was used to compare the distribution of the parameters between genders, modes of deliveries and gestational age. P value less than 0.05 was considered to declare statistical significance. Result The median values and 95 % reference interval for umbilical cord blood hematological parameters of newborns were as follows: WBC = 12.4 [6.6–19.4] x109/L, RBC = 4.51 [3.55–5.52] x1012/L, HGB = 15.8 [12.4–19.7] g/dL, HCT = 45.9[37.9–56.3]%, MCV = 102.1[83.9-111.6] fL, MCH = 35.3 [29.4–39.1] pg, MCHC = 34.3 [32.3–37.4] %, PLT = 236 [146–438] x109/L, LYM = 37.5 [16.6–63.0] %, MXD = 7.9[1.7–15.8] %, NEU = 53.7[30.3–78.4] %, RDW = 15.6[12.0–19.0]%, PDW = 11.0[9.1–15.7]% and MPV = 9.4[8.1–11.8] fL. The current study found no significant difference between genders, except RDW (P = 0.01), and gestational age group, but there was significant difference for WBC (p = 0.007), RBC (p = 0.018) and Absolute NEU (p = 0.001) by delivery type where newborns delivered through caesarean section had lower values for these three parameters compared to those with spontaneous delivery. Conclusions hematological reference intervals in cord blood were established for the first time from healthy newborns of Addis Ababa and its surrounding. The values are applicable for newborns from this area. Larger study throughout the country is warranted.

Umbilical Cord Blood Hemogram: What Is the Effect of Maternal Anemia?

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4536-4536
Author(s):  
Rithika Rajendran ◽  
Febe Renjitha Suman ◽  
Reddy Salmon Sudheer Raj ◽  
Paidipamula Rajesh Kanna ◽  
Naga Raju Borra
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Reticulocyte Count ◽  
Reference Interval ◽  
Mean Corpuscular Hemoglobin ◽  
Corpuscular Hemoglobin ◽  
Maternal Anemia ◽  
Significant Difference ◽  
Rbc Count

Abstract Introduction: Umbilical cord blood (UCB), a source of hematopoietic stem cells, represents neonatal blood and reflects the health of the newborn to a great extent. Establishing biological reference intervals is essential to discard samples before submitting for expensive investigations and storage. Also neonatal anemia has to be recognised early. Hence this study is undertaken to establish a biological reference interval for the UCB hemogram and to study the effect of maternal anemia on the fetus. Materials and methods: This is a prospective study conducted in two steps after Institutional Ethics Committee approval. In each step, 100 full term infants with normal birth weight and APGAR score delivered by spontaneous vaginal delivery were enrolled. In the first step, the mothers had hemoglobin (Hb) above 12 g/dL and no co-morbid conditions. In the second step, maternal hemoglobin cut offs of 12 g/dL and 10.9 g/dL were established. UCB was collected after clamping the cord in a K₂-EDTA evacuated tube. The blood was processed in Beckman Coulter LH 780 hematology analyzer. Delta check and manual count of RBC precursors was done by peripheral smear and reticulocyte count. Data was analysed using SPSS IBM statistics software version 19. The RBC parameters (RBC count, Hb, packed cell volume (PCV), mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW)) and RBC precursors between groups were compared. The changes according to the grade of anemia were analysed and compared with the biological reference interval. The maternal Hb was grouped in 1 g/dL differences and the Hb in the UCB of the respective neonates was correlated. Results: The biological reference interval for UCB hemogram was established. No significant difference was found in the RBC parameters in the UCB of neonates born to anemic and non-anemic mothers. Reticulocyte parameters namely reticulocyte count, absolute reticulocyte count, reticulocyte index and reticulocyte proliferation index showed significant increase in the UCB of neonates born to anemic mothers. No significant difference was found in the nucleated RBC (nRBC) count between the groups. When compared to the biological reference interval, MCH and MCHC were lower and reticulocyte parameters were higher in the UCB of neonates born to anemic mothers. A significant positive Pearson correlation was found between cord blood Hb and maternal Hb. Discussion: Through the UCB Hb correlated positively with maternal Hb, it has been found that maternal anemia does not cause fetal anemia. This may be due to high iron transfer from mother to fetus and maximally stimulated erythropoiesis at the end of gestation. However, significantly low MCH and MCHC values were seen in the UCB of neonates born to anemic mothers in comparison with the biological reference interval. This may be due to early decreased hemoglobin content within the cell which is compensated by the high RBC count. This is further confirmed by the significant elevation of reticulocyte parameters in the UCB of neonates born to anemic mothers. Conclusion: Maternal anemia depending on the severity causes chronic hypoxia so that the fetal bone marrow reacts to the effect of erythropoietin by increased erythropoiesis and RBC precursor release. Severe maternal anemia may cause neonatal anemia which needs further ferrokinetic studies. Maternal anemia in developing countries needs to be corrected. Also the biological reference interval established serves as a tool for neonatologists, transplant hematologists and future studies in UCB. Disclosures No relevant conflicts of interest to declare.

Cord-Blood High-Sensitivity Troponin-I Reference Interval and Association with Early Neonatal Outcomes

2021 ◽  
Author(s):  
Paul M. Ryan ◽  
Tapas Mondal ◽  
Kaaran Gupta ◽  
George Radovanovic ◽  
Edward Pugh ◽  
...  
Keyword(s):  
Birth Weight ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Gestational Age ◽  
Troponin I ◽  
Tertiary Care ◽  
High Sensitivity ◽  
Reference Interval ◽  
Nicu Admission

Objective This study was aimed to establish a reference interval for high-sensitivity cardiac troponin I (hs-cTnI) in umbilical cord blood of infants and to assess its association with the risk of predetermined early neonatal outcomes in a high-acuity tertiary care hospital. Study Design Umbilical cord-blood samples were collected and hs-cTnI was measured in all infants born between August 2015 and September 2015 at McMaster Children's Hospital (n = 256). Gestational age, birth weight, Apgar's scores, age in days at which feeding was established, neonatal intensive care unit (NICU) admission, and discharge in days after birth were recorded. Results The 90th, 95th, and 99th percentiles for the term infant subcohort were 19.75, 41.45, and 166.30 ng/L, respectively. We observed decreased mean gestational ages and birth weights in both the 90th (37.7 weeks; 2,961.4 g) and 95th percentiles (37.1 weeks; 2,709.9 g) when compared with the remaining infants. Moreover, levels of hs-cTnI were significantly higher in infants with respiratory distress requiring intervention (p < 0.05), low–birth weight infants (p < 0.01), preterm infants (p < 0.001), and those requiring NICU admission (p < 0.01). Multiple linear regression of the recorded demographic factors revealed prematurity (gestational age <35 weeks: coefficient 0.346 ± 0.160, p < 0.05; gestational age <37 weeks: coefficient 0.253 ± 0.105, p < 0.05) and male sex (coefficient 0.138 ± 0.047; p < 0.01) to be most predictive of log-hs-cTnI levels. Conclusion This study establishes the reference values for cord-blood hs-cTnI in infants at a tertiary care center. Premature and sick infants requiring NICU admission had significantly higher levels of hs-cTnI. Key Points

Inflammatory Markers in Umbilical Cord Blood from Small-For-Gestational-Age Newborns

2014 ◽  
Vol 33 (2) ◽  
pp. 114-118 ◽  
Author(s):  
Ulrik Lausten-Thomsen ◽  
Marianne Olsen ◽  
Gorm Greisen ◽  
Kjeld Schmiegelow
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Inflammatory Markers

scholarly journals T lymphocyte subsets of the umbilical cord blood of dogs

2009 ◽  
Vol 61 (4) ◽  
pp. 791-796 ◽  
Author(s):  
M.L.B. Cápua ◽  
A.E. Santana ◽  
A.P.M. Nakage ◽  
A.V. Godoy ◽  
A. Kataoka
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
T Lymphocyte ◽  
Umbilical Cord Blood ◽  
Blood Cells ◽  
Hematological Parameters ◽  
White Blood Cells ◽  
Hemoglobin Concentration ◽  
Cd4 Cells ◽  
T Lymphocyte Subsets

The hematological parameters red blood cells (RBC) and total white blood cells (WBC) counts, hematocrit, hemoglobin concentration, and RBC indexes (median corpuscular volume and median corpuscular hemoglobin concentration) were determined and T CD5+ lymphocytes and CD4+ and CD8+ subpopulations of the umbilical cord blood (UCB) of dogs were quantified by the cytofluorimetric technique. Nine adult Beagles, from two do five-year old, were used as control. The umbilical cord blood (UCB) was collected from 20 neonate dogs. The method for the UCB collection was adequate to obtain sufficient quantity of blood for the accomplishment of the hematological analyses and lymphocyte quantification. Cytoscopic preparations of the UCB suggested high erythropoietic activity. There was no difference for the global leukocyte and lymphocyte counts between the groups. UCB T lymphocyte counts were lower than those obtained for adult dogs. The proportion of CD4:CD8 showed a great dominance of T CD4+ cells over T CD8+ lymphocytes in UCB.

scholarly journals Replicated umbilical cord blood DNA methylation loci associated with gestational age at birth

Epigenetics ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. 1243-1258 ◽  
Author(s):  
Timothy P. York ◽  
Shawn J. Latendresse ◽  
Colleen Jackson-Cook ◽  
Dana M. Lapato ◽  
Sara Moyer ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Gestational Age ◽  
Gestational Age At Birth ◽  
Age At Birth

Culture of CD34+ Umbilical Cord Blood Progenitors with Notch Ligand Results in Enhanced and More Rapid Human Engraftment in a Preclinical NOD/SCID Mouse Model.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 190-190 ◽  
Author(s):  
Colleen Delaney ◽  
Irwin D. Bernstein
Keyword(s):  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Cultured Cells ◽  
Ex Vivo ◽  
Culture Period ◽  
Unrelated Donor ◽  
Culture Vessel ◽  
Notch Ligand ◽  
Significant Difference

Prior clinical studies have indicated that total nucleated and CD34+ cell dose is a critical determinant of hematopoietic reconstitution and survival after unrelated donor umbilical cord blood (UCB) transplantation. Efforts to overcome the problem of small cell numbers in UCB grafts by ex vivo expansion, primarily by culture with cytokines, have not met with success. We have previously shown that culture of CD34+CD38− UCB progenitors with the Notch ligand, Delta1, results in enhanced generation of NOD/SCID repopulating cells. Here we develop a clinically feasible cGMP method for Notch ligand-based expansion of cord blood precursors. Specifically, we investigated the use of CD34+ versus CD34+CD38− cells as a starting population, optimal cytokines and medium, selection of culture vessel and culture period for effects on generation of NOD/SCID repopulating cells. UCB progenitors were cultured in the presence of a Notch ligand form consisting of the extracellular domain of Delta1 fused to the Fc domain of human IgG1 (Delta 1ext-IgG) or control human IgG. Initial studies demonstrated optimal cytokines consisted of SCF, FL, TPO, IL6 and IL3, together with fibronectin fragments in serum free medium. There was no significant difference seen in the CD34 fold expansion with CD34+ versus CD34+CD38− starting cells, however, upon transplantation into NOD/SCID mice, there was a significant increase in the level of human engraftment seen with the CD34+ starting cell population (6.93% vs 2%; p=0.01). Further results from 5 independent experiments in which cord blood CD34+ progenitor cells were cultured for 17 days with immobilized Delta1extIgG or control resulted in a mean fold expansion of CD34+ cells of 230 (± 53) for the Delta cultured cells versus 65 (±31) for the control cultured cells (p=0.03). Delta cultured cells demonstrated significantly enhanced levels of human engraftment as measured by percent CD45 in the marrow of the animals at both 3 weeks (Delta1 15.5%, control 2.6%, uncultured 0.2%; p<0.0001) and at 9 weeks (Delta1 29.4%, control 8.9%, uncultured 7.3%; p<0.0001). We also found significantly greater numbers of SCID repopulating cells (SRC) detected 3 and 9 weeks following transplantation in the Delta1ext-IgG cultured cells compared to control cultured or non-cultured cells (frequency of SRC per 106: 3 weeks, 125 versus 37 or 8, respectively; p=0.0001; 9 weeks, 99 versus 56 or 15, respectively; p=0.01 and p=0.0001). Additional experiments demonstrated that the 17 day culture period was superior to shorter (10 days) or longer (21 days) periods. Relevant to anticipated administration of cultured cord blood units together with a second non-cultured unit in clinical trials, we determined the relative contribution to engraftment of co-infused expanded versus non-manipulated cells in immunodeficient mice, using tissue culture bags as a closed system. We found increased human engraftment in mice that received co-infusions of cultured and uncultured cells compared to either unit alone. Moreover, studies demonstrated that both units contributed to the observed human engraftment suggesting absence of cross-immunologic rejection. This data demonstrate the ability to ex vivo expand UCB repopulating cells using a clinically relevant Notch ligand-based closed culture system and suggests clinical evaluation of this approach to provide more rapid engraftment to overcome the major disadvantage of UCB transplantation.

Chromatographic Separation Of Fetal and Adult Hemoglobins For Nitric Oxide Quantification In Term Human Umbilical Cord Blood

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 2192-2192
Author(s):  
Daniel A. Riccio ◽  
Brendan Huang ◽  
Brian C. Antczak ◽  
Kristin W. Weaver ◽  
Amy P. Murtha ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cord Blood ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Lower Percentage ◽  
Human Umbilical Cord ◽  
Early Detection Of Disease ◽  
Blood Samples ◽  
Significant Difference ◽  
Hb Variant

Abstract Introduction Nitric oxide (NO) is a vasoactive molecule that can bind to hemoglobin (Hb) in the form of S-nitrosothiol (SNO) functionalities at the β93 cysteine residues. Red blood cells (RBCs) containing S-nitrosohemoglobin (SNO-Hb) are able to not only deliver oxygen, but release vasodilatory NO/SNO equivalents to enhance blood flow in order to match tissue oxygen demand (e.g., during hypoxic vasodilation). Newborn babies normally carry two variants of hemoglobin, adult (Hb A) and fetal (Hb F). It is well known that Hb F binds oxygen more tightly than Hb A in order to facilitate oxygen scavenging across the placenta from maternal Hb A. Given that SNO-Hb is preferentially formed on oxygenated Hb, we hypothesized that Hb F may also bind a higher concentration of NO. Previous studies examining the NO content of cord blood were disadvantaged by looking at cord blood Hb as a whole. To date, no attempt has been made to determine the basal levels of NO bound to each Hb variant independently. Therefore, we aimed to separate the variants and measure the NO/SNO content of Hbs F and A in order to establish basal levels for each variant in cord blood at term. We reasoned that the results could improve insight into mechanisms of abnormal perinatal transitions and the selection of therapies involving NO signaling and/or RBC transfusion. Methods Venous and arterial umbilical cord blood samples were collected immediately after normal term cesarean sections of infants with minimum gestational age of 37 weeks. RBC samples were washed in pH 7.4 phosphate buffered saline (PBS) with 100 µM diethylene triamine pentaacetic acid (DTPA) chelator to preserve SNOs, and hypotonically lysed. Total Hb was obtained through purification of the lysate through a Sephadex G-25 column. Partially purified Hb (200 µL) was loaded onto a HiTrap Q HP anionic exchange column (5 mL column volume with 34 µm bead size) and subjected to an increasing ionic strength gradient of 0–0.15M NaCl in pH 8.4 Tris buffer. Spectrophotometric analysis corroborated the complete separation of the variants. Isoelectric focusing on a Perkin Elmer Hemoglobin Resolve gel for 50 minutes at 1500 V and 10–15 °C was used in conjunction with an AFSC Hemopure control to identify the respective variants in each fraction. Each Hb variant was reconcentrated in pH 7.4 PBS with 100 µM DTPA via centrifugation through pre-rinsed 10 kDa MW cutoff centrifugal filters. The SNO/NO content of each variant was analyzed by photolysis-chemiluminescence of paired samples diluted to 100 μM Hb with/without 600 μM HgCl2. For samples with lower Hb concentration, a 6-fold molar excess of HgCl2 was also used. The Hg (mercury) acts to cleave NO bound to thiols (i.e., SNO) and is unreactive towards FeNO complexes; thus the difference in the paired sample peaks indicates the amount of SNO-Hb present in the sample. Results In arterial cord blood samples, the amount of SNO-Hb bound to each variant (i.e., fetal and adult) was found to average ∼5 x 10-4 mol SNO per mol of Hb tetramer (Figure 1A). There was no significant difference between Hb F and Hb A with regards to SNO-Hb. Venous cord blood samples had similar results. The amount of total NO (i.e., SNO-Hb and heme-bound NO) bound to each variant was significantly higher on Hb A in arterial samples. (Figure 1B, *, p value < 0.05 vs. Hb F by paired t-test). Conclusions Both Hb A and Hb F carry substantial and similar amounts of SNO adduct. Given the lower percentage (∼15-20%) of Hb A as a constituent in the total Hb of cord blood at term, the finding of a higher total NO content on Hb A than Hb F suggests that the presence of Hb A may be important to the total NO bioavailability in newborns. Vasodilator NO/SNO is known to be essential in the healthy cardiopulmonary transition to air breathing at birth. Thus, fundamental and translational studies assessing these species in newborns experiencing difficult transitions or pathophysiological states (e.g., persistent pulmonary hypertension of the newborn, PPHN) may provide potential biomarkers with utility in early detection of disease, prognosis, and intervention selection and management. The results and methodology presented here have broad applications to numerous areas of hematology and other medicine including neonatal intensive care, therapeutic induction of HbF in sickle cell disease patients, and decision-making in transfusion medicine. Disclosures: No relevant conflicts of interest to declare.

N-terminal pro-C-type natriuretic peptide, but not C-type natriuretic peptide, is greatly elevated in the fetal circulation

2004 ◽  
Vol 106 (5) ◽  
pp. 535-540 ◽  
Author(s):  
Timothy C. R. PRICKETT ◽  
Risto J. KAAJA ◽  
M. Gary NICHOLLS ◽  
Eric A. ESPINER ◽  
A. Mark RICHARDS ◽  
...  
Keyword(s):  
Cord Blood ◽  
Natriuretic Peptide ◽  
Umbilical Cord ◽  
Umbilical Cord Blood ◽  
Plasma Concentrations ◽  
Maternal Plasma ◽  
Fetal Tissues ◽  
Cord Plasma ◽  
Significant Difference ◽  
Gestational Group

We have identified recently a new peptide, NT-proCNP(1–50) (N-terminal pro-C-type natriuretic peptide), in the circulation of humans and sheep. A previous report of an elevated fetal–maternal gradient in immunoreactive CNP raised the possibility that processing and metabolism of proCNP may differ in maternal and fetal tissues. We therefore collected matching peripheral maternal and umbilical cord plasma samples at delivery from women with normotensive and pre-eclamptic pregnancies to investigate the presence and concentrations of CNP and NT-proCNP using HPLC and RIA. Plasma concentrations of NT-proCNP in normotensive umbilical cord plasma were 10-fold higher than maternal venous levels (246±17 compared with 24.3±1.8 pmol/l; P<0.001) and much higher than corresponding levels of CNP (3.6±0.4 compared with 1.8±0.3 pmol/l in the fetal and maternal plasma respectively; P<0.001). Although there was no significant difference between normotensive and pre-eclamptic plasma CNP concentrations in either maternal or umbilical cord blood, NT-proCNP showed a significant statistical interaction (F=5.8, P=0.025) between the source (maternal or fetal) and gestational group (normotensive or pre-eclamptic). Maternal NT-proCNP levels were raised in the pre-eclampsia group, whereas the converse was observed in umbilical cord blood. In conclusion, the greatly elevated ratio of NT-proCNP/CNP in fetal compared with maternal plasma suggests that synthesis, as well as clearance, of CNP (but not NT-proCNP clearance) are markedly increased in fetal tissues.

Sign in / Sign up

Export Citation Format

Share Document