Elsevier

Clinics in Perinatology

Volume 42, Issue 3, September 2015, Pages 483-497
Clinics in Perinatology

Reference Intervals in Neonatal Hematology

https://doi.org/10.1016/j.clp.2015.04.005Get rights and content

Section snippets

Key points

  • The various blood cell counts of neonates must be interpreted in accordance with high-quality reference intervals based on gestational and postnatal age.

  • Using very large sample sizes, we generated neonatal reference intervals for each element of the complete blood count (CBC).

  • Knowledge of whether a patient has CBC values that are too high (above the upper reference interval) or too low (below the lower reference interval) provides important insights into the specific disorder involved and in

Reference intervals

In adult medicine, the elements of the complete blood count (CBC) can be recognized as normal or abnormal by comparing the patient’s values with normal ranges established by drawing blood on large numbers of healthy adult volunteers. Normal ranges are not available for neonates, because of justified ethical concerns about drawing blood from healthy neonates for research purposes only. Consequently another approach is used, a concept termed reference intervals. These consist of 5th to 95th

Methodology

All reference intervals in this article were derived by identifying every CBC result performed on neonates in the Intermountain Healthcare system between 2005 and 2014. More than 350,000 individual test values were obtained on about 100,000 neonates. The number of values included in each reference interval varied by panel, ranging from a low of 3922 values for neutrophil counts of neonates of 22 to 28 weeks’ gestation to a high of 216,869 values for platelet counts in the first 90 days of life.

Individual reference intervals

Fig. 1, Fig. 2, Fig. 3, Fig. 4, Fig. 5, Fig. 6, Fig. 7, Fig. 8, Fig. 9, Fig. 10, Fig. 11, Fig. 12, Fig. 13, Fig. 14, Fig. 15, Fig. 16, Fig. 17, Fig. 18, Fig. 19, Fig. 20, Fig. 21, Fig. 22, Fig. 23 show the different neonatal CBC reference intervals. Each figure is constructed to show either the day of birth, giving reference intervals according to gestational age at birth, or postnatal age, giving reference intervals according to hours or days after birth. Where the CBC values for postnatal age

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    Citation Excerpt :

    The gestational age of each subject in the reference interval data set was derived from the neonatal records. The reference interval chart displaying the 5th, median, and 95th reference intervals for hemoglobin and hematocrit on the day of birth was published previously.4 Using those data, we began the present study by calculating the 1st percentile reference interval according to gestational age as our means of defining severe anemia at birth (Figure 1).

View all citing articles on Scopus

Disclosures: None.

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