Cord Blood Alkaline Phosphatase as a predictor of Neonatal Jaundice in full term neonates

AbstractBackgroundNeurological complications are common in the premature and full-term neonates admitted to the intensive care unit, but the diagnosis of these complications is often difficult to make. S100B protein, measured in cord blood, may represent a valuable tool to better identify patients at risk of brain injury.MethodsAs a first step, we established S100B cord blood serum reference intervals from 183 preterm and 200 full-term neonates. We then measured cord blood serum S100B to identify neurological complications in 272 neonates hospitalized at the neonatal intensive care unit (NICU). Diagnosis of brain injury relied on imaging examination.ResultsThe 95th percentiles of S100B concentration in cord blood were established as 1.21 μg/L for the 383 neonates, 0.96 μg/L for full-term neonates and 1.36 μg/L for premature neonates. Among the 272 neonates hospitalized at the NICU, 11 presented neurological complications. Using 1.27 μg/L as the optimal sensitivity/specificity threshold, S100B differentiate neonates with and without neurological complications with a sensitivity of 45.5% (95% confidence intervals [CI]: 16.7–76.6) and a specificity of 88.9% (95% CI: 84.4–92.4) (p = 0.006). In combination with arterial pH (<7.25), sensitivity increased to 90.9% (95% CI: 58.7–99.8), while specificity was 51.2% (95% CI: 44.8–57.7). The sensitivity is significantly (p = 0.03) increased in comparison to S100B alone. The specificity is significantly higher with S100B only than with pH + S100B (p < 0.001).ConclusionsCord blood S100B protein, in combination with arterial cord blood pH, has the potential to help clinicians to detect at birth neurological complications in neonates hospitalized in an NCIU.

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Granulocyte/Macrophage Colony-Forming Units from Cord Blood of Premature and Full-Term Neonates: Its Role in Ontogeny of Human Hemopoiesis

Pediatric Research ◽

10.1203/00006450-198812000-00010 ◽

1988 ◽

Vol 24 (6) ◽

pp. 701-702 ◽

Cited By ~ 5

Author(s):

Der-Cherng Liang ◽

Sheau-Wen Ma ◽

Marie Lin-Chu ◽

Chung-Chi Lan

Keyword(s):

Cord Blood ◽

Full Term ◽

Term Neonates ◽

Colony Forming Units ◽

Macrophage Colony

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Clot formation of neonates tested by thromboelastography correlates with gestational age

Thrombosis and Haemostasis ◽

10.1160/th09-05-0282 ◽

2010 ◽

Vol 103 (02) ◽

pp. 344-350 ◽

Cited By ~ 46

Author(s):

Tzipi Strauss ◽

Yael Levy-Shraga ◽

Bruria Ravid ◽

Irit Schushan-Eisen ◽

Ayala Maayan-Metzger ◽

...

Keyword(s):

Cord Blood ◽

Gestational Age ◽

Blood Clot ◽

Full Term ◽

Clot Formation ◽

Clotting Time ◽

Term Infants ◽

Term Neonates ◽

Pregnancy And Delivery ◽

Clot Formation Time

SummaryEvaluation of clot formation in neonates is troublesome. Our aim was to investigate cord blood clot formation of pre-term versus full-term infants and adults, using rotating thromboelastogram (ROTEM®, Pentafarm, Munich, Germany). ROTEM was investigated in cord blood of 184 full-term and 47 pre-term infants. Measurements of the clotting time (CT), clot formation time (CFT) and maximal clot firmness (MCF) were obtained in order to asses reference values for this age group, and compare between full-term and pre-term neonates and compared to adult controls. For each infant demographic information and data regarding pregnancy and delivery were gathered. Infants were prospectively followed until discharge. CT and CFT were significantly shorter among pre-term and term infants as compared to adults [median CT: 185, 194, 293 seconds respectively, p≤0.001, CFT: 80, 76, 103 seconds respectively, p≤0.001). MCF was lower in pre-term and term as compared to adults (p≤0.001) with significantly lower values in pre-term as compared to full-term neonates (p=0.004). Clotting time and MCF correlated with gestational age (R=0.132, p=0.045, R= 0.259, p<0.001, respectively). No association was found between any ROTEM values and the occurrence of post-natal complications in infants of our study group. This is the first study assessing clot formation by ROTEM in pre-term infants. Clot formation parameters of term and premature infants correlated with gestational age. The predictive value of clot formation tests in neonates deserves further attention.

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