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Published in: BMC Pediatrics 1/2021

Open Access 01-12-2021 | Research

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

Authors: Ammanuel Angelo, Girma Derbie, Asrat Demtse, Aster Tsegaye

Published in: BMC Pediatrics | Issue 1/2021

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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.
Literature
2.
go back to reference NCCLS. How to Define and Determine Reference Intervals in the Clinical Laboratory; Approved Guideline—Second Edition. NCCLS document C28-A2 [ISBN 1-56238-406-6]. NCCLS, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087 – 1898, USA 2000. NCCLS. How to Define and Determine Reference Intervals in the Clinical Laboratory; Approved Guideline—Second Edition. NCCLS document C28-A2 [ISBN 1-56238-406-6]. NCCLS, 940 West Valley Road, Suite 1400, Wayne, Pennsylvania 19087 – 1898, USA 2000.
4.
go back to reference Lanzkowsky P, Lipton JM, Fish JD. Hematological Reference Values. In: Lanzkowsky's Manual of Pediatric Hematology and Oncology, 6th end. London: Elsevier Inc; 2016. Appendix 1, 709-728. Lanzkowsky P, Lipton JM, Fish JD. Hematological Reference Values. In: Lanzkowsky's Manual of Pediatric Hematology and Oncology, 6th end. London: Elsevier Inc; 2016. Appendix 1, 709-728.
7.
go back to reference 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):320–324. 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):320–324.
9.
go back to reference Geffre A, Friedrichs K, Harr K, Concordet D, Trumel C, Braun JP. Reference values: a review. Vet Clin Pathol. 2009; 38(3): 288–298.CrossRef Geffre A, Friedrichs K, Harr K, Concordet D, Trumel C, Braun JP. Reference values: a review. Vet Clin Pathol. 2009; 38(3): 288–298.CrossRef
15.
go back to reference Samantaray R, Pradhan BB. Effect of Faeto-Maternal Factors on Haematological Parameters of Cord Blood. IOSR J Dent Med Sci. 2015; 14(5):92–96. Samantaray R, Pradhan BB. Effect of Faeto-Maternal Factors on Haematological Parameters of Cord Blood. IOSR J Dent Med Sci. 2015; 14(5):92–96.
16.
go back to reference 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. 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.
go back to reference Debbarma R, Debbarma B. Effect of Maternal Anaemia on Cord Haemoglobin and Birth Weight of Newborns. IOSR J Dent Med Sci. 2015; 14(7):19–21. Debbarma R, Debbarma B. Effect of Maternal Anaemia on Cord Haemoglobin and Birth Weight of Newborns. IOSR J Dent Med Sci. 2015; 14(7):19–21.
18.
go back to reference Dalal E, Shah J. A Comparative Study on Outcome of Neonates Born To Anemic Mothers versus Non Anemic Mothers. Natl J Med Res. 2014; 4(4):270–273. Dalal E, Shah J. A Comparative Study on Outcome of Neonates Born To Anemic Mothers versus Non Anemic Mothers. Natl J Med Res. 2014; 4(4):270–273.
20.
go back to reference Dane B, Arslan N, Batmaz G, Dane C. Does maternal anemia affect the newborn? Turk Arch Ped. 2013; 48:195–199.CrossRef Dane B, Arslan N, Batmaz G, Dane C. Does maternal anemia affect the newborn? Turk Arch Ped. 2013; 48:195–199.CrossRef
21.
go back to reference 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. 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.
23.
go back to reference Sharma JB, Shankar M. Anemia in Pregnancy. JIMSA. 2010; 23(4):253–260. Sharma JB, Shankar M. Anemia in Pregnancy. JIMSA. 2010; 23(4):253–260.
24.
go back to reference Adediran A, Gbadegesin A, Adeyemo TA, Akinbami A, 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.CrossRef Adediran A, Gbadegesin A, Adeyemo TA, Akinbami A, 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.CrossRef
28.
go back to reference Cloherty JP, Eichenwald EC, Hansen AR, Stark AR. Manual of Neonatal Care. Philadelphia: Lippincott Williams & Wilkins; 2012. Cloherty JP, Eichenwald EC, Hansen AR, Stark AR. Manual of Neonatal Care. Philadelphia: Lippincott Williams & Wilkins; 2012.
30.
go back to reference 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 Childbirth. 2018; 346. https://doi.org/10.1186/s12884-018-1972-1. 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 Childbirth. 2018; 346. https://​doi.​org/​10.​1186/​s12884-018-1972-1.
32.
go back to reference Younis MS, Elgari MM, Mohamed B, Idris EE. Effect of delivery mode on newborns cord blood hematological parameters. Cukurova Med J. 2017; 42(4):735–740.CrossRef Younis MS, Elgari MM, Mohamed B, Idris EE. Effect of delivery mode on newborns cord blood hematological parameters. Cukurova Med J. 2017; 42(4):735–740.CrossRef
33.
go back to reference 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(3):155–160.CrossRef 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(3):155–160.CrossRef
34.
go back to reference 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. 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.
35.
go back to reference Oliveira FdeC, Assis KF, Martins MC, do Prado MRMC, Ribeiro AQ, SantAna LFdaR et al. Timing of clamping and factors associated with iron stores in full-term newborns. Rev Saúde Pública 2014; 48(1):10–18.CrossRef Oliveira FdeC, Assis KF, Martins MC, do Prado MRMC, Ribeiro AQ, SantAna LFdaR et al. Timing of clamping and factors associated with iron stores in full-term newborns. Rev Saúde Pública 2014; 48(1):10–18.CrossRef
36.
go back to reference Ramasethu J. Complications of Vascular Catheters in the Neonatal Intensive Care Unit. Clin Perinatol 2008; 35:199–222.CrossRef Ramasethu J. Complications of Vascular Catheters in the Neonatal Intensive Care Unit. Clin Perinatol 2008; 35:199–222.CrossRef
40.
go back to reference WHO. Report of a WHO Technical Consultation on Birth Spacing. Geneva, Switzerland 13–15 June 2005; 1–45. www.who.org. WHO. Report of a WHO Technical Consultation on Birth Spacing. Geneva, Switzerland 13–15 June 2005; 1–45. www.​who.​org.
41.
go back to reference Sysmex Corporation. Operator’s Manual: Kx-21 Automated Hematology Analyzer. Kobe, Japan 2000; 1-306. Sysmex Corporation. Operator’s Manual: Kx-21 Automated Hematology Analyzer. Kobe, Japan 2000; 1-306.
42.
go back to reference Elgari MM, and Waggiallah HA. Cord Blood Hematological Profile of Sudanese Neonates at Birth in Khartoum State. NJIRM. 2014; 5(4):22–25. Elgari MM, and Waggiallah HA. Cord Blood Hematological Profile of Sudanese Neonates at Birth in Khartoum State. NJIRM. 2014; 5(4):22–25.
44.
go back to reference Alharbi S, Alkhotani A. Hematological Reference Values for Full-Term, Healthy Newborns of Jeddah, Saudi Arabia. J Clin Neonatol. 2017; 6(1):19–22.CrossRef Alharbi S, Alkhotani A. Hematological Reference Values for Full-Term, Healthy Newborns of Jeddah, Saudi Arabia. J Clin Neonatol. 2017; 6(1):19–22.CrossRef
45.
go back to reference 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.PubMed 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.PubMed
46.
go back to reference 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.CrossRef 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.CrossRef
47.
go back to reference 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(3):179–184.PubMed 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(3):179–184.PubMed
49.
go back to reference 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.CrossRef 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.CrossRef
50.
go back to reference 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.CrossRef 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.CrossRef
52.
go back to reference Freise KJ, Schmidt RL, Gingerich EL, Veng-Pedersen P, Widness JA. The effect of anticoagulant, storage temperature and dilution on cord blood hematology parameters over time. Int J Lab Hematol. 2009; 31:496–504.CrossRef Freise KJ, Schmidt RL, Gingerich EL, Veng-Pedersen P, Widness JA. The effect of anticoagulant, storage temperature and dilution on cord blood hematology parameters over time. Int J Lab Hematol. 2009; 31:496–504.CrossRef
53.
go back to reference Mendelson CR. Fetal-Maternal Hormonal Signaling in Pregnancy and Labor. Mol Endocrinol. 2009; 23(7):947–954.CrossRef Mendelson CR. Fetal-Maternal Hormonal Signaling in Pregnancy and Labor. Mol Endocrinol. 2009; 23(7):947–954.CrossRef
Metadata
Title
Umbilical cord blood hematological parameters reference interval for newborns from Addis Ababa, Ethiopia
Authors
Ammanuel Angelo
Girma Derbie
Asrat Demtse
Aster Tsegaye
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-021-02722-z

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