Hematological parameters immediately after birth in twins and higher order multiples

Area of Science:

• Neonatal Hematology
• Perinatal Medicine
• Comparative Pediatrics

Background:

• Hematological parameters are crucial for neonatal assessment.
• Reference ranges for newborns are typically established for singletons.
• Multiple gestations present unique physiological conditions impacting neonatal health.

Purpose of the Study:

• To establish reference values for neonatal hematological parameters in twins and higher-order multiples.
• To compare these values against gestation- and sex-matched singletons.
• To identify significant differences in hematological profiles between multiple births and singletons.

Main Methods:

• Retrospective matched cohort study design.
• Inclusion of hematological data from multiples and matched singletons (2007-2009).
• Exclusion of infants with known confounding maternal or fetal conditions; statistical comparison using t-tests, chi-square, and nonparametric tests.

Main Results:

• 363 multiples were matched with 363 singletons.
• Multiples had lower birth weights and higher in-vitro fertilization rates.
• Multiples exhibited marginally higher mean hemoglobin but significantly lower nucleated red cells, total white blood cells (WBCs), absolute neutrophils, monocytes, and immature WBCs compared to singletons.

Conclusions:

• Neonatal multiples demonstrate distinct hematological profiles compared to singletons.
• Significantly lower total WBC, absolute neutrophils, monocytes, and eosinophils are observed in multiples.
• These hematological differences, particularly in WBC and neutrophil counts, must be accounted for when interpreting neonatal laboratory results in multiple births.