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Haemoglobin and red blood cell reference intervals during infancy

Larsson, Marie LU ; Hellström-Westas, Lena LU ; Hillarp, Andreas LU ; Karlsland Åkeson, Pia LU ; Domellöf, Magnus ; Askelöf, Ulrica ; Götherström, Cecilia and Andersson, Ola LU orcid (2022) In Archives of Disease in Childhood 107(4). p.351-358
Abstract

OBJECTIVES: There is a need for updated haematological reference data in infancy. This study aimed to define intervals for haemoglobin and red blood cell biomarkers based on data from a large cohort of longitudinally followed Swedish infants. DESIGN: Longitudinal cohort study. SETTING: Two Swedish study centres. PARTICIPANTS: Three community-based populations including 442 presumably healthy infants born at term and with umbilical cord clamping delayed to 30 s or more after birth. METHODS: Blood samples were collected from umbilical cord blood (a), at 48-118 hours (b), at 4 months (c) and at 12 months (d). Reference intervals as the 2.5th and 97.5th percentiles were calculated in coherence with Clinical and Laboratory Standards... (More)

OBJECTIVES: There is a need for updated haematological reference data in infancy. This study aimed to define intervals for haemoglobin and red blood cell biomarkers based on data from a large cohort of longitudinally followed Swedish infants. DESIGN: Longitudinal cohort study. SETTING: Two Swedish study centres. PARTICIPANTS: Three community-based populations including 442 presumably healthy infants born at term and with umbilical cord clamping delayed to 30 s or more after birth. METHODS: Blood samples were collected from umbilical cord blood (a), at 48-118 hours (b), at 4 months (c) and at 12 months (d). Reference intervals as the 2.5th and 97.5th percentiles were calculated in coherence with Clinical and Laboratory Standards Institute guidelines. RESULTS: Reference intervals for haemoglobin (g/L) were: (a) 116-189, (b) 147-218, (c) 99-130, (d) 104-134, and for mean cell volume (fL): (a) 97-118, (b) 91-107, (c) 71-85, (d) 70-83. Reference intervals for erythrocyte counts, reticulocyte counts, reticulocyte haemoglobin, mean cell haemoglobin and mean cell haemoglobin concentration were also estimated. According to the WHO definition of anaemia, a haemoglobin value less than 110 g/L, 16% of this presumably healthy cohort could be classified as anaemic at 12 months. CONCLUSION: We found mainly narrower reference intervals compared with previously published studies. The reference intervals for each parameter varied according to the infants' age, demonstrating the necessity of age definitions when presenting infant reference intervals. The discrepancy with the WHO classification for anaemia at 12 months, despite favourable conditions in infancy, needs future investigation.

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author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
biochemistry, growth, health services research, statistics, technology
in
Archives of Disease in Childhood
volume
107
issue
4
pages
8 pages
publisher
BMJ Publishing Group
external identifiers
  • pmid:34674992
  • scopus:85127729092
ISSN
1468-2044
DOI
10.1136/archdischild-2021-321672
language
English
LU publication?
yes
id
413fc5d7-7b04-4340-a19d-b032525eba5f
date added to LUP
2021-11-01 09:32:00
date last changed
2024-09-07 23:26:41
@article{413fc5d7-7b04-4340-a19d-b032525eba5f,
  abstract     = {{<p>OBJECTIVES: There is a need for updated haematological reference data in infancy. This study aimed to define intervals for haemoglobin and red blood cell biomarkers based on data from a large cohort of longitudinally followed Swedish infants. DESIGN: Longitudinal cohort study. SETTING: Two Swedish study centres. PARTICIPANTS: Three community-based populations including 442 presumably healthy infants born at term and with umbilical cord clamping delayed to 30 s or more after birth. METHODS: Blood samples were collected from umbilical cord blood (a), at 48-118 hours (b), at 4 months (c) and at 12 months (d). Reference intervals as the 2.5th and 97.5th percentiles were calculated in coherence with Clinical and Laboratory Standards Institute guidelines. RESULTS: Reference intervals for haemoglobin (g/L) were: (a) 116-189, (b) 147-218, (c) 99-130, (d) 104-134, and for mean cell volume (fL): (a) 97-118, (b) 91-107, (c) 71-85, (d) 70-83. Reference intervals for erythrocyte counts, reticulocyte counts, reticulocyte haemoglobin, mean cell haemoglobin and mean cell haemoglobin concentration were also estimated. According to the WHO definition of anaemia, a haemoglobin value less than 110 g/L, 16% of this presumably healthy cohort could be classified as anaemic at 12 months. CONCLUSION: We found mainly narrower reference intervals compared with previously published studies. The reference intervals for each parameter varied according to the infants' age, demonstrating the necessity of age definitions when presenting infant reference intervals. The discrepancy with the WHO classification for anaemia at 12 months, despite favourable conditions in infancy, needs future investigation.</p>}},
  author       = {{Larsson, Marie and Hellström-Westas, Lena and Hillarp, Andreas and Karlsland Åkeson, Pia and Domellöf, Magnus and Askelöf, Ulrica and Götherström, Cecilia and Andersson, Ola}},
  issn         = {{1468-2044}},
  keywords     = {{biochemistry; growth; health services research; statistics; technology}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{4}},
  pages        = {{351--358}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Archives of Disease in Childhood}},
  title        = {{Haemoglobin and red blood cell reference intervals during infancy}},
  url          = {{http://dx.doi.org/10.1136/archdischild-2021-321672}},
  doi          = {{10.1136/archdischild-2021-321672}},
  volume       = {{107}},
  year         = {{2022}},
}