Reticulocyte Hemoglobin Content During the First Month of Life in Critically Ill Very Low Birth Weight Neonates Differs From Term Infants, Children, and Adults

Al-Ghananim, Raeda; Nalbant, Demet; Schmidt, Robert L.; Cress, Gretchen A.; Zimmerman, M. Bridget; Widness, John A.

doi:10.1002/jcla.21859

Cited by 33 publications

(38 citation statements)

References 36 publications

(90 reference statements)

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“…On average, Ret-H e dropped by approximately 1 pg per day in term infants whereas it decreased by around 2 pg per day in preterm infants. A similar decline in Ret-H e with PNA was seen previously in a small cohort of very preterm infants [4]. Christensen et al [5 ]established reference ranges for Ret-H e for the first 90 days after birth in a large cohort of preterm and term infants.…”

Section: Discussionmentioning

confidence: 60%

“…Ret-H e reference ranges in the first 24 h after birth are slightly lower in very preterm than in term infants [3]; this may even become more pronounced in the days that follow. It is known from recent studies that Ret-H e quickly drops after birth [4,5], but to what extent and if this is influenced by gestational age (GA) is less clear. Our hypothesis is that Ret-H e declines more markedly in preterm than in term infants.…”

Section: Introductionmentioning

confidence: 99%

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Reticulocyte Haemoglobin Content Declines More Markedly in Preterm than in Term Infants in the First Days after Birth

Lorenz¹,

Arand²,

Springer³

et al. 2017

Neonatology

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Background: Reticulocyte haemoglobin content, i.e., the reticulocyte equivalent (Ret-H_e), seems to be a promising parameter for the detection of iron deficiency (ID) in neonates because it can be obtained as part of a reticulocyte count, with no additional blood loss and at no extra cost. Due to the short life span of reticulocytes, Ret-H_e reflects current iron availability for erythropoiesis more accurately than other common erythrocyte indices. Objective: We aimed to evaluate postnatal changes in Ret-H_e within the first days after birth in term and preterm infants with the hypothesis that preterm infants experience a more pronounced postnatal reduction in Ret-H_e when compared to term infants. Methods: We conducted retrospective analyses of clinically indicated blood samples. Paired t test and mixed regression modelling were used. Results: In total, 805 blood samples obtained from 207 term and 295 preterm infants were analysed. Ret-H_e decreased by 1.5 pg per day (regression coefficient [95% CI] -1.5 [-1.8 to -1.2] pg, p < 0.0001). This drop was more significant in preterm infants (regression coefficient -2.2 [-2.6 to -1.8] pg, p < 0.0001) than in term infants (regression coefficient -0.8 [-1.3 to -0.2] pg, p < 0.01, p_interaction < 0.0001). Conclusion: Ret-H_e declined within the first days after birth. The observed changes with postnatal age were more pronounced in preterm than in term infants. Further studies are needed to evaluate if these changes are due to developing ID or other causes.

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Section: Discussionmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 99%

Reticulocyte Haemoglobin Content Declines More Markedly in Preterm than in Term Infants in the First Days after Birth

Lorenz¹,

Arand²,

Springer³

et al. 2017

Neonatology

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“…Factor contributing to decline in hematological parameters in the newborn was due to decrease in blood erythropoietin concentration soon after birth, reducing the erythropoietic rate. Also, transient hemolysis is high during the first days or week after birth as during the remainder of healthy life, this transient hemolysis is a general physiologic occurrence during the first week after birth similar to neocytolysis a rapid decline in hemoglobin, because of hemolysis, seen in mountaineers after they descend to sea level following many weeks at high altitude [8][9][10][11][12]. Significant hematologic differences are seen between term and preterm infants and among newborns, infants, young children and older children.…”

Section: Introductionmentioning

confidence: 99%

Hematological Differences in Newborn and Aging: A Review Study

Jacob¹

2016

HTIJ

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The aim of this study was to highlight the possible cause of hematological differences in newborn and aging for appropriate hematological reference values to be used for treatment at all developmental stages. The neonate (newborn infant) older child and adult exhibit profound hematologic differences from one another because children mature at different rates, quantitative and qualitative differences are present as a reflection of the developmental changes during fetal hematopoiesis which correlate with gestational age. At birth, hematological of term newborns are significantly higher than those of older children and adults and in preterm neonates the differences are even more pronounced. It is inappropriate to use adult reference ranges for the assessment of pediatric blood values. Geriatric medicine is a rapidly growing branch of medicine, care of the elderly has become a growing trend as the life expectancy of the population continues to increase. Hematological changes are obvious in both the neonates and the elderly persons and at such; different hematological variables must be implemented in various developmental stages of the neonates as well as the different classes of aged elderly individuals. Also among the elderly, certain hematological disorders are more common which need urgent attention of their physicians. This review highlighted some major factors that responsible for hematological differences in newborn and aging.

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“…Previously reported reticulocyte haemoglobin content values vary between 31.7 and 35.7 pg (mean/median) and between 25.2 and 33.1 pg for the 2.5th percentile [16,17,18,19]. This variability might be caused by variations in the proportion of very preterm infants, time of sampling, samples size and device used.…”

Section: Discussionmentioning

confidence: 99%

Reference Ranges of Reticulocyte Haemoglobin Content in Preterm and Term Infants: A Retrospective Analysis

Lorenz

Arand²,

Springer³

et al. 2016

Neonatology

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Background: Despite iron supplementation, some preterm infants develop iron deficiency (ID). The optimal iron status parameter for early detection of ID has yet to be determined. Objective: To establish reference ranges for reticulocyte haemoglobin content (Ret-He) in preterm and term infants and to identify confounding factors. Methods: Retrospective analyses of Ret-He and complete blood count in infants with a clinically indicated blood sample obtained within 24 h after birth. Results: Mean (SD) Ret-He was 30.7 (3.0) pg in very preterm infants with a gestational age (GA) of <30 weeks (n = 55), 31.2 (2.6) pg in moderately preterm infants (GA 30-36 weeks, n = 241) and 32.0 (3.2) pg in term infants (GA ≥37 weeks, n = 216). The 2.5th percentile of Ret-He across all GA groups was 25 pg, with a weak correlation between Ret-He and GA (r = 0.18). Moreover, only weak/no correlations were found between Ret-He and C-reactive protein (r = 0.18), interleukin 6 (IL-6) (r = 0.03) and umbilical artery pH (r = -0.07). There was a slight variation in Ret-He with mode of delivery [normal vaginal delivery: 32.3 (3.2) pg, secondary caesarean section (CS): 31.4 (3.0) pg, instrumental delivery: 31.3 (2.7) pg and elective CS: 31.2 (2.8) pg]. Conclusion: GA at birth has a negligible impact on Ret-He, and the lower limit of the normal reference range in newborns within 24 h after birth can be set to 25 pg. Moreover, Ret-He seems to be a robust parameter which is not influenced by perinatal factors within the first 24 h after birth.

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Reticulocyte Hemoglobin Content During the First Month of Life in Critically Ill Very Low Birth Weight Neonates Differs From Term Infants, Children, and Adults

Cited by 33 publications

References 36 publications

Reticulocyte Haemoglobin Content Declines More Markedly in Preterm than in Term Infants in the First Days after Birth

Reticulocyte Haemoglobin Content Declines More Markedly in Preterm than in Term Infants in the First Days after Birth

Hematological Differences in Newborn and Aging: A Review Study

Reference Ranges of Reticulocyte Haemoglobin Content in Preterm and Term Infants: A Retrospective Analysis

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