GET THE APP

Journal of Hematology & Thromboembolic Diseases

Journal of Hematology & Thromboembolic Diseases
Open Access

ISSN: 2329-8790

Research Article - (2021)Volume 9, Issue 3

Umbilical Cord Blood Haematological Parameters Reference Interval for New-borns in St. Peter Specialized Hospital Addis Ababa, Ethiopia

Ammanuel Angelo1,2, Girma Derbie1, Million Mola1, Daniel Asrat3 and Aster Tsegaye2*
 
*Correspondence: Aster Tsegaye, Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia, Tel: +25145363, Email:

Author info »

Abstract

Background: Several factors like altitude, age, sex, pregnancy, socioeconomic status, lifestyle and race influence hematological reference interval (RIs), which are critical to support appropriate 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.

Objective: To generate reference interval for umbilical cord blood hematological parameters of newborns at St Peter Specialized Hospital 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 a total of 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 percentile (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 groups.

Result: The combined reference interval for umbilical cord blood hematological parameters of newborns with the median and 95% reference value of cord blood parameters were as follows for WBC= 12.4 [6.55-19.35], RBC= 4.51 [3.55-5.52], HGB= 15.80 [12.41-19.65], HCT= 45.9[37.9-56.3], MCV=102.10[83.90-111.55], MCH= 35.30 [29.35-39.10], MCHC= 34.3 [32.3-37.40], PLT= 236 [146-438], LYM= 37.5% [16.6-63.0%], MXD= 7.9%[1.65-15.75%], NEU= 53.7%[30.3-78.3], RDW= 15.6[12.0-19.0], PDW=11.0[9.1-15.7] and MPV= 9.4[8.1-11.8]. The current study found no significance difference between genders, except RDW (P=0.01) and gestational age group, but there was significance difference for WBC (p=0.007), RBC (p=0.018) and Absolute NEU (p=0.001).

Conclusion: Since this study is pioneer of its kind with regards to hematological reference intervals in cord blood, the values obtained from our study provide reference intervals for some hematological parameters in healthy newborns of Addis Ababa and its surrounding special weredas. However, the results need to be confirmed by larger samples from different centers throughout the country.

Keywords

CBC; Reference interval; Umbilical cord blood; Neonates

Introduction

Reference intervals aid in the interpretation of laboratory data for appropriate result interpretation, clinical trials, and selection of participants for vaccine trials [1]. These values are affected by several factors including age, sex, race, geographical location and dietary pattern [2]. A wealth of published studies demonstrated the age related changes in hematological parameters. The neonate exhibit profound quantitative as well as qualitative hematologic differences compared to older child and adults [3], at birth, hematological parameters of term newborns are significantly higher than those of older children and adults [4,5]. Due to thespecific nature of RIs and biological variations it is inappropriate to use adult reference ranges for the assessment of Pedi blood [6,7]. A reference interval obtained from somewhere else and utilizing to population of interest could potentially lead to inappropriate patient management and unnecessary use of resources [8,9]. Cord blood hematological parameters reference intervals are vital in neonatal care and transplantation medicine [10,11]. Cord blood is a blood collected from long and helical cord that connects the fetus with the mother for substances exchange [12]. Establishing normal neonatal reference interval has been difficult because blood has not been drawn on healthy neonates of similar ages and other neonatal or maternal factors needed to be considered [13-16].

According to different studies maternal anemia had effect on cord blood hemoglobin and new born weight [17-20], though routine hematological values of newborns are independent to that of maternal hematological values [21, 22]. This may be due to high micronutrient intake inadequacy in pregnancy [23-25]. Factors like smoking habit [26], heavily drinking alcohol [27], medical problems like diabetic mellitus, eclampsia, hypertension [28-30] and mode of deliveries and frequency of pregnancy affect the hematological profile of neonates [31-33]. Also during the sample collection procedure though cord blood collection safe way to collect sample compared to cannula and other vascular catheters which cause thrombophlebitis, infection, and extravasation [34], the delayed cord clamping and umbilical cord milking had comparable effect on hematological parameters [35-36].

In spite of the fact that reference range can play an important role in guiding the interpretation of laboratory results in assessing the hematological changes, there is no published reference interval for hematological parameters in cord blood of Ethiopians.

Methods

A cross-sectional study was conducted from January 1 to March 31, 2019 in Addis Ababa, Ethiopia at an elevation of about 2440 m (about 8000 ft) above sea level, among 139 newborns delivered in St. Peter Specialized Hospital using convenient non-probability techniques. Priori selection method was implemented to include eligible mothers aged 18 to 45 years with no medical conditions (infectious (e.g. Hepatitis B, HIV, Syphilis), chronic (e.g. Insulindependent diabetes mellitus), obstetric (e.g. less than six months from abortion, preeclampsia) and psychological problems) and social habits (e.g. smoking, heavily alcohol drinking) by using diagnostic tests (lab tests, ultrasound) and history from the card. Also mothers who had Hgb >= 11.0g/dL and interpregnancy interval of more than or exactly 18 months as per WHO recommendation included (51, 52). Whereas, posteriori selection method was used to include eligible newborns who were term (37- 42 weeks) and had 5th minute Apgar score of >=7 and birth weight of term newborn within 2.5-4 Kg (4). Babies with respiratory distress, meconium stain, gross congenital anomalies, umbilical cord with true knot, and babies delivered by instrumental deliveries were excluded.

Data Collection Procedure

All the professionals who were participated in data collection were oriented about the aim of the study, in selecting study participants, data confidentiality, safety and precautions to follow in collecting, transporting, analyzing and storing cord blood samples. Predesigned questionnaire was used to collect demographic information and a brief medical history from consented mother. The umbilical cord clamped (in <1min after birth); 2-3 ml of blood were collected by Midwives or operation room (OR) nurse by EDTA tube and well mixed (10x) sample was transported to the laboratory for analysis.

Screening Tests

The laboratory screening tests for pregnant mother was done only for those tests were not done, missed or suspicious about the result during the antenatal care (ANC) follow up. The routine serological screening tests were Hepatitis B surface antigen test, HIV and syphilis antibody test. The ultrasonography test was also used to rule out fetal gross congenital anomalies.

Hematological Analysis

Complete blood count (CBC) tests namely WBC count, Diff count (NEU, LYM and MXD), RBC, HGB, HCT, MCV, MCH, MCHC, RDW, PLT, MPV and PDW were analyzed using Sysmex KX-21N, a speedy and 18 parameters performing automated hematology analyzer by the three detector blocks (WBC (DC detection method), HGB (Non-cyanide HGB method) RBC and PLT (DC Detection method)). Peripheral blood smears were prepared using wright’s stain for cord blood samples for investigation of red blood cell morphology, white blood cell and platelets abnormalities.

Statistical Analysis

All the data from the questionnaires and laboratory results were coded and checked for completeness. Then data were entered and analysed using SPSS-version 23 statistical software for windows. 2.5th and 97.5th percentiles for each haematological parameter with 90% CI reference Intervals for 139 new-borns of both genders were determined according to Clinical Laboratory Standard Institute (CLSI) guideline (2) and descriptive statistic. The non-parametric Independent Mann-Whitney U test was used to compare the distribution of the parameters between genders, delivery modes, and gestational age groups. Additionally, descriptive statistics (minimum, maximum, mean, SD, median) were also determined.

Ethical Considerations

The study was conducted after getting ethical clearance and support letter from the Department Research and Ethics Committee (DREC) of the Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University and St. Peter Specialized Hospital research department. The mother of neonates was informed about the aim of the study, participation and confidentiality of the information.

Results

A total of 139 healthy full-term newborns consisting of 67[47.9%] males and 72[51.8%] females (Table 1) were enrolled in this crosssectional study conducted in St. Peter Specialized Hospital from January 1 to March 31, 2019. About 15.8% of the mothers were from outside Addis, 84.9% were literate, and 47.5% (66/139) were having first time delivery.

Table 1 Demographic and Medical Information

Information Frequency Percent
Age of Mother (Years) 18-31   115 82.7
  31-45   24 17.3
Residence Addis Ababa   117 84.2
  Outside Addis   22 15.8
Ababa
Educational level Illiterate   21 15.1
  Literate   118 84.9
Employment Status Employed   62 44.6
  Unemployed   77 55.4
Marital Status Married   133 95.7
  Other   6 4.3
Pregnancy History None   66 47.5
  Yes   73 52.5
Pregnancy Interval (n=73)* 1-1year & 6months 6 8.2
  >=2years   67 91.8
Delivery mode Previously SVD 56 76.7
    CS 17 23.3
  Currently SVD 93 66.9
    CS 46 33.1
Sex of Baby Male   67 48.2
  Female   72 51.8
Weight of Baby 2-3Kg   74 53.2
  >3Kg   65 46.8
Gestational age 37-39.1 weeks   60 43.2
  39.2-42 weeks   79 56.8

On the other hand, for all hematological parameters there were no statistically significant difference within gestational age groups [37-39.1 versus 39.2-42 months] (p>0.05) (Table 2). Independent Mann- Whitney U (Wilcoxon rank-sum) test between delivery modes shows significant difference (p<0.05) of which newborns delivered through C/S had lowered value for WBC=11.1[6.6- 19.4], RBC=4.39[3.55- 5.52], and absolute NEU =6.0[2.7-12.8] compared to newborns delivered through SVD with value for WBC=12.9[6.6-19.4], RBC=4.55[3.55-5.52], and absolute NEU =7.6[2.7-12.8] (p<0.05). Sex specific 2.5th and 97.5th percentile for complete blood count parameters from umbilical cord blood is summarized in Table 3. Statistically significant differences by sex were not detected for any of the parameters except RDW-CV in which females showed lower median value (p <0.05) than males. The combined median and 95% reference value of cord blood parameters as shown in Table 3 were for WBC = 12.4 x109/L [6.6- 19.4], RBC = 4.51 x1012/L [3.55-5.52], HGB = 15.8g/dL [12.4- 19.7], HCT = 45.9% [37.9-56.3], MCV= 102.1fL [83.9-111.6], MCH = 35.3pg [29.4-39.1], MCHC = 34.3% [32.3-37.4], PLT = 236 x109/L[146-438], LYM = 37.5% [16.6-63.0%], MXD = 7.9% [1.7-15.8%], and NEU = 53.7% [30.3-78]. The study also tried to compare the established cord blood RI with that provided by Sysmex for 0- 24 hours old newborns and other previous studies.

Table 2 Shows Independent (2 Groups) Mann-Whitney U Test in 95% Confidence Interval with Significance Level 0.05

Parameters P- value by sex P-value by mode of delivery P-value by gestational age
WBC(x109/L) 0.787 0.007 0.366
RBC(x1012/L) 0.075 0.018 0.852
HGB (g/dL) 0.374 0.11 0.904
HCT (%) 0.861 0.193 0.707
MCV (fL) 0.171 0.117 0.99
MCH (Pg) 0.139 0.094 0.832
MCHC (g/L) 0.386 0.519 0.54
RDW-CV(%) 0.01 0.318 0.197
PLT (x109/L) 0.369 0.291 0.855
LYM% 0.274 0.348 0.325
MXD% 0.807 0.666 0.915
NEU% 0.227 0.262 0.315
LYM# 0.188 0.42 0.781
MXD# 0.657 0.157 0.765
NEU# 0.684 0.001 0.264
PDW-CV(%) 0.199 0.296 0.188
MPV (fL) 0.913 0.858 0.503

Table 3: Percentile Reference Intervals for umbilical cord hematological parameters by Sex of Newborns from January 1 to March 31, 2019 G.C in St. Peter Specialized Hospital, Addis Ababa, Ethiopia

Parameter Sex N Median Min Max 2.5 97.5 P-value
WBC (x109/L) M 67 12.6 6.5 19.6 6.6 19.3 0.787
  F 72 12.4 5.8 23.5 6.1 23.2  
  Combined 139 12.4 5.8 23.5 6.6 19.4  
RBC (x1012/L) M 67 4.59 3.54 5.7 3.59 5.59 0.075
  F 72 4.44 3.1 5.7 3.37 5.3  
  Combined 139 4.51 3.1 5.7 3.55 5.52  
HGB (g/dL) M 67 15.9 12.3 20 12.4 19.8 0.374
  F 72 15.7 10.8 20.6 11.1 18.8  
  Combined 139 15.8 10.8 20.6 12.4 19.7  
HCT (%) M 67 46 36 60.2 37.9 57.8 0.861
  F 72 45.45 36.4 61.8 37.3 56.3  
  Combined 139 45.9 36 61.8 37.9 56.3  
MCV (fL) M 67 102 81.9 115.5 82.1 112.8 0.171
  F 72 102.3 85.4 123.3 88.5 113.5  
  Combined 139 102.1 81.9 123.3 83.9 111.6  
MCH (Pg) M 67 35.1 28.6 39.7 28.8 39.4 0.139
  F 72 35.3 27.8 41.1 31.6 38.7  
  Combined 139 35.3 27.8 41.1 29.4 39.1  
MCHC (g/L) M 67 34.6 32.6 37.5 32.8 37.2 0.386
  F 72 34.3 30 37.9 31 37.7  
  Combined 139 34.3 30.2 37.9 32.3 37.4  
PLT (x109/L) M 67 230 145 469 146.7 466.2 0.369
  F 72 241.5 141 433 145.95 418.2  
  Combined 139 236 141 469 146 438  
%LYM M 67 36.6 4.8 71.2 10.8 64.6 0.274
  F 72 37.8 14.7 76 19.4 66.4  
  Combined 139 37.5 4.8 76 16.6 63  
%MXD M 67 8.3 1.5 17.8 1.7 15.8 0.807
  F 72 7.85 0 17.3 0 16.6  
  Combined 139 7.9 0 17.8 1.7 15.8  
%NEU M 67 54.7 22.5 88.4 26.9 84.1 0.227
  F 72 53.4 18.6 82.3 29.7 75.4  
  Combined 139 53.7 18.6 88.4 30.3 78.4  
#LYM M 67 4.4 0.8 7.7 1.9 7.7 0.188
  F 72 4.6 1.7 10.6 1.9 10.4  
  Combined 139 4.5 0.8 10.6 1.9 8.3  
#MXD M 67 1 0 2.4 0.1 2.3 0.657
  F 72 1 0 2.5 0 2.4  
  Combined 139 1 0 2.5 0.1 2.4  
#NEU M 67 6.8 1.9 15.7 2 15.4 0.684
  F 72 6.3 2.5 11.2 2.8 10.8  
  Combined 139 6.6 1.9 15.7 2.7 12.9  
RDW-CV (%) M 67 16 12.9 18.3 13 18.3 0.01
  F 72 15 12 19 12 19  
  Combined 139 15.6 12 19 12 19  
PDW-CV (%) M 67 11.2 9.1 16.5 9.3 16.2 0.199
  F 72 10.8 8.6 15.8 8.6 14.8  
  Combined 139 11 8.6 16.5 9.1 15.7  
MPV(fL) M 67 9.4 7 11.3 7.4 11.2 0.913
  F 72 9.35 8 12.5 8.1 12.3  
  Combined 139 9.4 7 12.5 8.1 11.8  

Most studies present their findings as Mean±SD and hence the comparison was made accordingly as described in Table-4 (All tables are found at the end of this article)

Table 4 Mean±SD or Median Comparison with Previous Studies and other given reference values

Our Study Sysmex KX-21 From Book Sudan Nigeria S.Arabia Pakistan
(0-24hrs newborns) (58) (47) (46) (43) (41)
Parameter Median Mean±SD RI RI Mean±SD Mean±SD Median Mean±SD
WBC 12.6 12.4±3.38 9.0-30.0 5.0-23.0 12.3±4.17 13.1±5.20 16.1 13.7±4.00
RBC 4.5 4.51±4.49 4.1-6.7 3.13-4.85 4.34±0.60 4.05±0.55 5.1 -
HGB 15.8 15.8±1.64 15.0-24.0 11.3-17.6 14.4±1.55 13.9±1.50 17.7 15.4±1.90
HCT 45.9 46.1±4.62 44-70 46-75 44.1±5.14 44.8±5.78 53.2
MCV 102.1 101.2±5.97 102-115 99-115 105.5±5.14 110.4±11.88 106 103.4±4.60
MCH 35.3 35.1±1.97 33.0-39.0 - 33.5±1.99 32.6±4.13 35.5 33.8±1.60
MCHC 34.3 34.5±1.17 32.0-36.0 - 33.1±1.19 29.8±1.64 33.2
RDW-CV 15.6 15.4±1.60 11.8-15.6 - 19.8±4.26 18.5±18
PLT 236 245.5±69.78 140-385 180-428 261± 83.16 225.1±72.21 234 285±62
LYM% 37.5 38.2±10.96 - - - - - -
MXD% 7.9 8.0±3.44 - - - - - -
NEU% 53.7 53.9±10.84 - - - - - -
#NEU 6.6 6.7±2.42 6.0-26.0 1.7-19.0 - - 7.7±3.00 -
#LYM 4.5 4.7±1.93 2.3-10.8 1.0-11.0 - - 5.1±1.80 -
#MXD 1 1.1±0.88 0.1-3.6 0.2-5.7 - - - -
PDW 11 11.6±2.22 - - - - - -
MPV 9.4 9.5±0.90 - - - - - -

Discussion

Comparison of results according to sex, delivery modes and gestational age group were done. There were no statistically significant gender difference (p>0.05) for all haematological parameters except RDW, which was a consistent finding with that of Greece, in addition to WBC, NEU and PLT [37]. Other previous studies from Korea, South India, Nepal, Saudi Arabia, Iran, Iraq, Nigeria and Sudan on the other hand, conclude there were no statistically significant differences by gender at this early life [38-47].

In the current study all the measured values were located within interval compared to reference value given for Sysmex KX-21 haematology analyser new-borns (0-24hrs) reference interval. Even though, the current study has lowered and narrowed reference interval for WBC, RBC, HGB, HCT and absolute differential counts (#NEU, #LYM, #MXD) parameters. On the other hand, there were no significant difference of MCH and MCHC reference interval of our findings to that of them.

In the current study, there were higher RBC, HGB and HCT values compared to Taiwan, Greece, Korea, South India, Pakistan, Nepal, Iraq, Nigeria and Sudan [33, 37-42, 45-47]. Our findings for both MCH and MCHC were also higher than those from Taiwan, South India, Nepal, Iraq, Nigeria and Sudan [33, 39, 42, 45-47], these might be due to our study was performed on high altitude and mode of deliveries which was majorly spontaneous vaginal delivery; also supported by previous studies by Quiser DH et al [16], Younis et al, El Gendy et al and YH Chang et al [31-33]. Birth is stressful event accompanied with hormone regulated inflammatory action which increase cell mobilization [47-55]. MCV value in this study was surprisingly lower from all the studies included in this literature [33, 37-47]. RDW values in our finding was lower than Saudi Arabia [43], Iran [44] and Nigeria [46]; this might be due to nutritional variation [50] but higher from that of Greece [37].

In the current study, we found higher total WBC compared to studies from Taiwan, Greece, Korea, Nepal and Iraq [33, 37, 38, 42, 45]. This might be due to spontaneous vaginal delivery was the major mode of delivery in our country which affect the fetal hemogram [51-53]. .However, the reference values from South India[39], Saudi Arabia [43], Pakistan [40, 41], and Nigeria [46] are slightly higher than our findings. On the differential part, we found higher neutrophil value compared to Taiwan, Korea and Pakistan [33, 38, 40, 41]. However, we found lower lymphocyte and mixed parts when we come across with most of the studies included in this literature may be due to nutrition and ethnic variation [48-50].

In the present study, the PLT value was higher than Taiwan, Korea, Nepal and Nigeria [33,38, 42, 46]; however, lower than South India, Pakistan, Saudi Arabia, Iran, Iraq and Sudan [39, 40, 41, 43-45]. On the other hand, the platelet indices (MPV=8.1-11.8 and PDW=9.1-15.7) values in the current study were lower than findings from Iran (MPV=8.5-11.6 and PDW=9.4-16.4) but higher than Greece (MPV=6.0- 10.0)p [37,44]. There might be possibly due to sample collection, processing and analysis may greatly affect reference interval establishment as described by different textbooks and literatures [14,33,35,56-58].

Conclusion

Since this study is pioneer of its kind with regards to haematological reference intervals in cord blood, the values obtained from our study could provide reference intervals for some haematological parameters in healthy new-borns (0-24rs) of Addis Ababa and its surrounding special whereas. However, the results need to be confirmed by larger samples from different centres throughout the country.

References

  1. Zeh CE, Odhiambo CO, Mills LA. Laboratory reference intervals in Africa. Blood Cell-An Overview of Studies in Hematology; IntechOpen: London, UK. 2012:303-320.
  2. Sasse EA. How to define and determine reference intervals in the clinical laboratory; approved guideline. NCCLS documents C28-A2. 2000.
  3. Proytcheva MA. Issues in neonatal cellular analysis. American journal of clinical pathology. 2009;131(4):560-573.
  4. Jacob EA. Hematological differences in newborn and aging. Hematol Transfus Int J. 2016; 3(3); 178-190.
  5. Glasser L, Sutton N, Schmeling M, Machan JT. A comprehensive study of umbilical cord blood cell developmental changes and reference ranges by gestation, gender and mode of delivery. J Perinatol. 2015; 35. 469–475.
  6. Huma T, Waheed U. The Need to Establish Reference Ranges. Public Health and Biological Sciences. 2013; 2(2):188-190.
  7. Tauseef K, Ali N, Ahmed S, Zafar H, Anwar J. Variation in reference values of hematological parameters between regional and international literature amongst the neonates. ISRA Med J. 2011; 3(1); 304-320.
  8. Berg J, Lane V. Pathology Harmony; a pragmatic and scientific approach to unfounded variation in the clinical laboratory. Annals of Clin Biochem. 2011; 48:195-197.
  9. Geffre A, Friedrichs K, Harr K, Concordet D, Trumel C, Braun JP. Reference values: a review. Vet Clin Pathol. 2009; 38(3); 288-298.
  10. Carroll PD, Christensen RD. New and underutilized uses of umbilical cord blood in neonatal care. Maternal Health, Neonatol Perinatol. 2015; 1(16); 1-7.
  11. Roura S, Pujal GM, Gálvez-Montón C, Bayes-Genis A. The role and potential of umbilical cord blood in an era of new therapies. Stem Cell Research & Therapy. 2015; 6(123); 1-11.
  12. Spurway J, Logan P, Pak S. The development, structure and blood flow within the umbilical cord with particular reference to the venous system. ajum. 2012; 15 (3); 97-102.
  13. Henry E, Chritensen RD. Reference Intervals in Neonatal Hematology. Clin Perinato. 2015; 1- 15.
  14. Sikaris KA. Physiology and its Importance for Reference Intervals. Clin Biochem Rev. 2014; 35 (1); 1-12.
  15. Samantaray R,Pradhan BB. Effect of Faeto-Maternal Factors on Haematological Parameters of Cord Blood. OSR J Dental and Med Sci. 2015; 14(5); 92-96
  16. Qaiser DH, Sandila MP, Kazmi T, Ahmed ST. Influence of Maternal Factors on Hematological Parameters of Healthy Newborns of Karachi. Pak J Physiol 2009; 5(2); 34-37.
  17. Debarma R, Debarma B. Effect of Maternal Anaemia on Cord Haemoglobin and Birth Weight of Newborns. Den Med Sci. 2015; 14(7):19-21.
  18. Dalal E, Shah J. A Comparative Study on Outcome of Neonates Born To Anemic Mothers versus Non Anemic Mothers. Nat J Med Research. 2014; 4(4); 270-273.
  19. Rajendran R, Suman FR, Sudheer Raj RS, Kanna PR, Borra NR. Umbilical Cord Blood Hemogram: What Is the Effect of Maternal Anemia? Blood J. 2015; 126:4526; 1-6.
  20. Dane B, Arslan N, Batmaz G, Dane C. Does maternal anemia affect the newborn? Turk Arch Ped. 2013; 48:195-199.
  21. Qaiser DH, Sandila MP, Omair A, Ghori GM. Correlation of Routine Haematological Parameters Between Normal Maternal Blood and the Cord Blood of Healthy Newborns in Selected Hospitals of Karachi. College of Physicians and Surgeons Pakistan. 2013; 23 (2):128- 131.
  22. Timilsina S, Karki S, Gautam A, Bhusal P, Paudel G, Sharma D. Correlation between maternal and umbilical cord blood in pregnant women of Pokhara Valley: a cross sectional study. BMC Pregnancy and Childbirth. 2018; 18(70).
  23. Sharma JB, Shankar M. Anemia in Pregnancy. jimsa. 2010; 23(4); 253-260.
  24. Adewumi A, Abidoye G, Titilope AA, Akinsegun AA, Osunkalu V, Ogbenna A et al. Cord blood hemoglobin and ferritin concentrations in newborns of anemic and non-anemic mothers in Lagos, Nigeria. Niger Med J. 2013; 54(1); 22-26.
  25. Terefe B, Birhanu A, Nigussie P, Tsegaye A. Effect of Maternal Iron Deficiency Anemia on the Iron Store of Newborns in Ethiopia. 2015; 1-6.
  26. Kataoka MC, Pinho Carvalheira AP, Ferrari AP, Malta MB, de Barros Leite Carvalhaes , de Lima Parad. Smoking during pregnancy and harm reduction in birth weight: a cross- sectional study. BMC Pregnancy and Childbirth 2018; 18(67); 1-10.
  27. Nykjaer C, Alwan NA, Greenwood DC, B Simpson NA, M Ha AW, Cade JE et al. Maternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort. J Epidemiol Community Health 2014; 0:1-8.
  28. Cloherty JP, Eichenwald EC, Hansen AR, Stark AR. Manual of Neonatal Care. Philadelphia: Lippincott Williams & Wilkins; 2012; 1-1029.
  29. Mahran A, Fares H, Elkhateeb R, Ibrahim M, Bahaa H, Sanad A et al. Risk factors and outcome of patients with eclampsia at a tertiary hospital in Egypt. BMC Pregnancy and Childbirth .2017; 17:435; 1-7.
  30. Rawlins B, Plotkin M, Rakotovao JP, Getachew A, Vaz M, Ricca J et al. Screening and management of preeclampsia and eclampsia in antenatal and labor and delivery services: findings from cross-sectional observation studies in six sub-Saharan African countries. BMC Pregnancy and Childbirth. 2018; 1-11.
  31. El Gendy FM, Allam AA, Allam MM,Allam RK. Haematological parameters of newborns delivered vaginally versus caesarean section. Menoufia Med J.2016; 29:259-264.
  32. Younis MS, Elgari MM, Mohamed BA , Idris EE. Effect of delivery mode on newborns cord blood hematological parameters. Cukurova Med J. 2017; 42(4):735-740.
  33. Chang YH, Yang SH, Wang TF, Lin TY, Yang KL , Chen SH. Complete Blood Count Reference Values of Cord Blood in Taiwan and the Influence of Gender and Delivery Route on Them. J Pediatr Neonatol. 2011; 52:155-160.
  34. Ramasethu J. Complications of Vascular Catheters in the Neonatal Intensive Care Unit. Clin Perinatol 2008; 35:199-222.
  35. Jaiswal P, Upadhyay A, Gothwal S, Singh D, Dubey K, Garg A et al. Comparison of Umbilical Cord Milking and Delayed Cord Clamping in Term Neonates: A Randomized Controlled Trial. Acad J Pediatr Neonatol. 2015; 1(1); 1-7.
  36. de Cássia Carvalho FO, Assis KF, Martins MC, Cardoso do Prado MRC, Ribeiro AQ, da Rocha LF et al. Timing of clamping and factors associated with iron stores in full-term newborns. Rev Saúde Pública 2014; 48(1); 10-18.
  37. Katsares V, Paparidis Z, Nikolaidou E, Karvounidou I, Ardelean KA, Drossas N et al. . Reference Ranges for Umbilical Cord Blood Hematological Values. Lab med. 2009; 40(7); 437- 439.
  38. Lee HR, Shin S, Yoon JH, Kim BJ, Hwang KR, Kim JJ et al Complete Blood Count Reference Values of Donated Cord Blood from Korean Neonates. Korean J Lab Med. 2009; 29:179-184.
  39. Suman FR, Sundheer Raj RH, Priyathersini N, Rajendran R, Rashmika R , Ramadoss U. Biological Reference Interval for Hematological Profile of Umbilical Cord Blood: A Study Conducted at A Tertiary Care Centre in South India. Clin Diag Research. 2015; 9(10); 7-9.
  40. Qaiser DH, Ahmed ST, Sandila MP , Kazmi T. Hematological reference values for full term, healthy, newborns of Karachi, Pakistan. jpma. 2009; 59(618); 1-10.
  41. Pasha W, Ali W, Ahmed N, Khattak AL, Idris M,  Nayyer ZA. Reference Hematological Values For Full Term Healthy Newborns From Rural Sindh, Pakistan. J Ayub Med Coll Abbottabad 2015; 27(2):375-377.
  42. Basnet S, Singh SK, Sathian B , Mishra R. Reference Range for Hematological Values in Umbilical Cord Blood in Pokhara, Nepal. J Nepal Paediatr Soc. 2016; 36(2):160-164.
  43. Alharbi S, Alkhotani A. Hematological Reference Values for Full-Term, Healthy Newborns of Jeddah, Saudi Arabia. J Clin Neonatol. 2017; 6; 19-22.
  44. Keramati MR, Mohammadzadeh A, Farhat AS, Sadeghi R. Determination of Hematologic Reference Values of Neonates in Mashhad - Iran. Int J Hematol Oncol. 2011; 21(2); 101-105.
  45. Al-Marzoki JM, Al-Maaroof ZW, Kadhum AH. Determination of reference ranges for full blood count parameters in neonatal cord plasma in Hilla, Babil, Iraq. Blood Med. 2012; 3:113-118.
  46. Adewumi A, Titilope AA, Akinsegun AA, Abidoye G, Ebele U and Sulaimon AA Cord blood full blood count parameters in Lagos, Nigeria. Pan African Medical Journal. 2014; 17(192); 1-5.
  47. Elgari MM, and Waggiallah HA. Cord Blood Hematological Profile of Sudanese Neonates at Birth in Khartoum State. NJIRM. 2014; 5(4):22-25.
  48. Haddy TB, Rana SR, Castro O. Benign ethnic neutropenia: What is a normal absolute Neutrophil count? J Lab Clin Med 1999; 133:15-22.
  49. Hsieh M, Chin K, Link B, Stroncek D, Wang E, Everhart J et al. Benign Ethnic Neutropenia in Individuals of African Descent: Incidence, Granulocyte Mobilization, and Gene Expression Profiling. Blood. 2005; 106(11); 1-5.
  50. Maggini S, Adeline Pierre A, Calder PC. Immune Function and Micronutrient Requirements Change over the Life Course. Nutrients. 2018; 10; 1-27.
  51. WHO. Hemoglobin concentration for the diagnosis of anemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva, World Health Organization, 2011
  52. Report of a WHO Technical Consultation on Birth Spacing. Geneva, Switzerland 13–15 June 2005; 1-45. www.who.org.
  53. Mendelson CR. Fetal-Maternal Hormonal Signaling in Pregnancy and Labor. Mol Endocrinol. 2009; 23(7):947-954.
  54. Yektaei-Karin E, Moshfeg A, Lundahl J, Berggren V, Hansson LO, Marchini G. The stress of birth enhances in vitro spontaneous  and IL-8-induced neutrophil chemotaxis  in the human. Pediatr Allergy Immunol. 2007(18); 643-651.
  55. Liu T, Zhang L, Joo D , Sun SC. NF-κB signaling in inflammation. 2017; 2; 1-9.
  56. Sysmex Corporation. Operator's Manual: Kx-21 Automated Hematology Analyzer. Kobe, Japan 2000; 1-306.
  57. Freise KJ, Schmidt RL, Gingerich EL, Veng-Pedersen, Widness.The effect of anticoagulant, storage temperature and dilution on cord blood hematology parameters over time. Int Jnl. Lab. Hem. 2009; 31; 496–504.

Author Info

Ammanuel Angelo1,2, Girma Derbie1, Million Mola1, Daniel Asrat3 and Aster Tsegaye2*
 
1Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
2St. Peter Specialized Hospital, Addis Ababa, Ethiopia
3Department of Pediatrics and Child Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
 

Citation: Angelo A (2021) Umbilical Cord Blood Hematological Parameters Reference Interval for Newborns in St. Peter Specialized Hospital Addis Ababa, Ethiopia . J Hematol Thrombo Dis 9:334. DOI: 10.24105/2329-8790.2021.9.3 34

Received: 19-Jan-2021 Accepted: 15-Mar-2021 Published: 22-Mar-2021

Copyright: © 2021 Angelo A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Top