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Issues in neonatal cellular analysis
1From the Feinberg School of Medicine of Northwestern University and Children's Memorial Hospital, Chicago, IL 60614, USA.
American Journal of Clinical Pathology
|March 18, 2009
Summary
Neonatal hematologic values differ from adults due to developmental changes. This review examines these differences, influencing factors, and interpretation challenges for accurate neonatal laboratory testing.
Area of Science:
- Pediatric Hematology
- Clinical Pathology
- Neonatal Medicine
Background:
- Hematologic values in neonates exhibit significant quantitative and qualitative differences compared to older children and adults.
- These variations are attributed to developmental changes during fetal hematopoiesis and correlate with gestational age.
- Term newborns present higher hemoglobin, mean corpuscular volume, and white blood cell counts than older individuals, with preterm neonates showing even more pronounced differences.
Purpose of the Study:
- To explore the distinct hematologic values in term and preterm neonates.
- To identify major factors influencing neonatal hematologic parameters from a laboratory perspective.
- To address challenges in interpreting neonatal hematologic test results and propose solutions.
Main Methods:
- Review of developmental hematopoiesis and normal hematologic values in neonates.
- Examination of preanalytic factors affecting neonatal blood samples, including blood volume, sampling site, and crying.
- Analysis of analytic interferences impacting hematologic test accuracy.
- Discussion of interpretation challenges related to neonatal reference intervals and critical value reporting.
Main Results:
- Neonatal hematologic values are significantly higher than in adults, particularly in preterm infants.
- Preanalytic factors such as limited blood availability, sampling site, and patient distress (crying) can interfere with results.
- Analytic interferences further complicate accurate hematologic testing in neonates.
- Challenges exist in establishing appropriate neonatal reference intervals and reporting critical values.
Conclusions:
- Understanding developmental hematopoiesis is crucial for interpreting neonatal blood counts.
- Careful consideration of preanalytic and analytic factors is essential for reliable neonatal laboratory results.
- Addressing issues with neonatal reference intervals and critical value reporting is necessary for improved clinical decision-making.
