Abstract
Objectives
Red blood cell parameters are frequently used biomarkers when assessing clinical status in newborns and in early childhood. Cell counts, amounts, and concentrations of these parameters change through gestation and after birth. Robust age-specific reference intervals are needed to optimize clinical decision making.
Methods
The Copenhagen Baby Heart Study (CBHS) and the COMPARE study are prospective cohort studies including red blood cell parameters from 7,938 umbilical cord blood samples and 295 parallel venous blood samples from newborns with follow-up at two and at 14–16 months after birth.
Results
For venous blood at birth, reference intervals for hemoglobin, erythrocytes, and hematocrit were 145–224 g/L, 4.1–6.4 × 1012/L, and 0.44–0.64, respectively. Hemoglobin, erythrocytes, and hematocrit were lower at birth in children delivered by prelabor cesarean section compared to vaginal delivery. Conversion algorithms based on term newborns were: venous hemoglobin=(umbilical cord hemoglobin˗86.4)/0.39; venous erythrocytes=(umbilical cord erythrocytes-2.20)/0.44; and venous hematocrit=(umbilical cord hematocrit-0.24)/0.45.
Conclusions
This study presents new reference intervals for red blood cell parameters in early childhood, describes the impact of delivery mode, and provide exact functions for converting umbilical cord to venous blood measurements for term newborns. These findings may improve clinical decision making within neonatology and infancy and enhance our clinical understanding of red blood cell parameters for health and diseases in early life.
Funding source: Lundbeckfonden
Funding source: Snedkermester Sophus Jacobsen og Hustru Astrid Jacobsens Fond
Funding source: The Research Council at Herlev-Gentofte Hospital
Funding source: Candy Foundation
Funding source: Hjerteforeningen
Funding source: Research Council at the capital Region of Denmark
Acknowledgments
We thank the staff at the maternity wards at Herlev Hospital, Hvidovre Hospital and Rigshospitalet. We are grateful to the staff and participants of the Copenhagen Baby Heart Study and the COMPARE study for their important contributions to the cohorts.
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Research funding: This work was supported by the Research Council at Herlev-Gentofte Hospital, Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond, The Danish Heart Foundation, The Research Council at the capital Region of Denmark, the Candy Foundation, and the Lundbeck Foundation. The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The research related to human use has complied with all relevant national regulations, institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ Institutional Review Board the Regional Ethics Committee of the Capital Region of Denmark (H-16001518), and the Danish Data Protection Agency (I-Suite no.: 04546, ID-no. HGH-2016-53).
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/cclm-2022-0826).
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