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Vol. 99, No. 4, 2011
Issue release date: June 2011
Section title: Original Paper
Neonatology 2011;99:289–294
(DOI:10.1159/000320148)

Reference Ranges for Blood Concentrations of Nucleated Red Blood Cells in Neonates

Christensen R.D. · Henry E. · Andres R.L. · Bennett S.T.
aWomen and Newborn’s Clinical Program, Intermountain Healthcare, and bMcKay-Dee Hospital Center, Ogden, Utah, cInstitute for Healthcare Delivery Research, and dDivision of Fetal/Maternal Medicine, Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, Utah, and eDepartment of Pathology, Intermountain Medical Center, Murray, Utah, USA

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 5/26/2010
Accepted: 7/23/2010
Published online: 12/4/2010
Issue release date: June 2011

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 1

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO

Abstract

Background: Previous studies reported a relationship between high nucleated red blood cells (NRBC) in neonates and the development of intraventricular hemorrhage (IVH) and/or retinopathy of prematurity (ROP). Objective: We sought to (1) establish reference ranges for NRBC in neonates based on a large data set, (2) compare NRBC from automated versus manual counts, (3) determine the effect of an elevated NRBC, on the day of birth, on the odds of developing grade ≧3 IVH or ROP. Methods: We analyzed all NRBC obtained during 8.5 years in a multihospital system, displaying the 5th and 95th percentile limits according to gestational age and postnatal age. Results: NRBC counts were retrieved from 61,932 neonates, 26,536 of which were excluded from the data set. Comparing 9,000 samples run simultaneously on manual versus automated methods, the manual counts yielded slightly higher counts, but the difference is likely insignificant clinically. Altitude of the birth hospital did not correlate with NRBC, and no correlations were observed with cord pH or 1- or 5-min Apgar. An NRBC count >95th percentile limit was associated with higher odds of developing a grade ≧3 IVH (OR 4.28; 95% CI 3.17–5.77) and grade ≧3 ROP (OR 4.18; 95% CI 2.74–6.38). Conclusion: The figures of this report display reference ranges for NRBC according to gestational age and postnatal age. An NRBC count above the 95% limit at birth is associated with a higher risk of subsequently developing severe IVH and severe ROP. We speculate that this association is because an elevated NRBC count is a marker for prenatal hypoxia.


  

Author Contacts

Robert D. Christensen, MD
Women and Newborn’s Clinical Program, Intermountain Healthcare
4403 Harrison Blvd
Ogden, UT 84403 (USA)
Tel. +1 801 387 4300, Fax +1 801 387 4316, E-Mail rdchris4@ihc.com

  

Article Information

Received: May 26, 2010
Accepted after revision: July 23, 2010
Published online: December 4, 2010
Number of Print Pages : 6
Number of Figures : 3, Number of Tables : 1, Number of References : 21

  

Publication Details

Neonatology (Fetal and Neonatal Research)

Vol. 99, No. 4, Year 2011 (Cover Date: June 2011)

Journal Editor: Halliday H.L. (Belfast), Speer C.P. (Würzburg)
ISSN: 1661-7800 (Print), eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: 5/26/2010
Accepted: 7/23/2010
Published online: 12/4/2010
Issue release date: June 2011

Number of Print Pages: 6
Number of Figures: 3
Number of Tables: 1

ISSN: 1661-7800 (Print)
eISSN: 1661-7819 (Online)

For additional information: http://www.karger.com/NEO


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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