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Age-related reference values for ionized calcium in the first week of life in premature and full-term neonates
Insights
This study establishes reference values for ionized calcium in premature and full-term neonates. These findings are crucial for monitoring calcium levels in newborns and ensuring proper care.
Area of Science:
- Neonatal physiology
- Pediatric biochemistry
- Clinical chemistry
Background:
- Accurate reference ranges for ionized calcium are essential for neonatal care.
- Previous studies may not fully cover the dynamic changes in ionized calcium during early neonatal life, particularly in premature infants.
Purpose of the Study:
- To determine and present age-specific reference values for ionized calcium in capillary blood of healthy premature neonates.
- To compare ionized calcium levels in full-term neonates with mild hyperbilirubinemia or born via C-section to those of healthy full-term neonates.
- To establish comprehensive reference ranges for ionized calcium in both premature and full-term neonates.
Main Methods:
- Measurement of ionized calcium in anaerobic capillary blood samples.
- Inclusion of healthy premature neonates (gestational age 33-36 weeks) and full-term neonates.
- Statistical comparison (unpaired t-test) of ionized calcium levels between different neonatal groups.
Main Results:
- Reference values for premature neonates showed variations with age, ranging from 1.17 +/- 0.12 to 1.40 +/- 0.16 mmol/l.
- No statistically significant differences in age-related ionized calcium values were observed between full-term neonates with mild hyperbilirubinemia or born by C-section and healthy full-term neonates.
- Pooled data for 168 full-term neonates provided age-related reference values, with ionized calcium levels ranging from 1.19 +/- 0.12 to 1.40 +/- 0.10 mmol/l.
Conclusions:
- Established age-specific reference ranges for ionized calcium in premature neonates.
- Confirmed that mild hyperbilirubinemia or C-section delivery do not significantly alter ionized calcium levels in full-term neonates compared to healthy controls.
- Provided comprehensive ionized calcium reference values for both premature and full-term neonates, aiding clinical decision-making.
Abstract:
Reference values for ionized calcium were measured in anaerobic samples of capillary blood from 22 healthy premature neonates, gestational age 33-36 weeks, birth weight 1660-2480 g. Reference values (mean +/- 2SE) for premature neonates aged 5-12, 13-19, 25-48, 51-72, 77-99, 108-140, 150-185 h were: 1.21 +/- 0.16, 1.17 +/- 0.12, 1.21 +/- 0.16, 1.28 +/- 0.18, 1.34 +/- 0.14, 1.38 +/- 0.13, 1.40 +/- 0.16 mmol/l, respectively. Ionized calcium in 59 full-term neonates with mild pathological hyperbilirubinaemia (no phototherapy needed) and 28 neonates born by section (no neonatal complications) showed no statistical difference (unpaired t-test) in age-related values compared with matching healthy neonates with no clinical remarks. Data for full-term neonates were pooled and age-related reference values (mean +/- 2SE) for ionized calcium in capillary whole blood for 168 full-term neonates, gestational age 38-41 weeks, birth weight 2550-4700 g, aged 1-12, 13-24, 25-48, 49-72, 73-99, 99-120, 121-144, 146-168, 178-264 h were: 1.24 +/- 0.11, 1.19 +/- 0.12, 1.21 +/- 0.13, 1.22 +/- 0.14, 1.29 +/- 0.17, 1.35 +/- 0.12, 1.37 +/- 0.12, 1.38 +/- 0.16, 1.40 +/- 0.10 mmol/l, respectively.