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Establishment of Complete Capillary Blood Counts Reference Intervals for Young Children in Local Area, China
Insights
This study establishes local pediatric reference intervals for capillary complete blood counts in Nantong, China. These region-specific values are crucial for accurate diagnosis and health assessment in young children.
Area of Science:
- Pediatric Hematology
- Clinical Pathology
- Laboratory Medicine
Background:
- Accurate blood count reference intervals (RIs) are vital for pediatric health assessment.
- Existing national RIs (WS/T 779-2021) may not be universally applicable due to regional variations.
- This study addresses the need for locally determined RIs in young children.
Purpose of the Study:
- To establish and validate region-specific pediatric reference intervals for capillary complete blood count (CCBC) parameters.
- To compare these local RIs with national (WS/T 779-2021) and international data.
- To provide a benchmark for similar pediatric populations.
Main Methods:
- Analyzed capillary blood samples from 4,758 healthy children aged 28 days to 3 years.
- Followed Clinical and Laboratory Standards Institute (CLSI) EP28-A3c guidelines for RI determination.
- Utilized standard procedures and CLSI guidelines for statistical analysis.
Main Results:
- Established pediatric RIs for 18 CCBC parameters.
- Observed age-related variations in White Blood Cell (WBC) differentials (NE, LYM).
- Defined RIs for Red Blood Cell (RBC) parameters (MCV, MCH) considering age and gender differences.
- Noted an increasing trend in Platelet (PLT) counts.
- Validation confirmed high accuracy (90.11%-100%) of the established RIs.
- Local RIs were more concentrated than WS/T 779-2021 with minor boundary differences.
Conclusions:
- Region-specific pediatric reference intervals are essential for accurate clinical interpretation.
- The study provides local CCBC reference intervals for young children in Nantong.
- These findings serve as a benchmark for pediatric hematology in the Yangtze River Delta region.
Background:
Blood count reference intervals are important to diagnose diseases and assess overall health, especially for young children. Although, in 2021, the National Health Commission of the People's Republic of China issued "Reference intervals of blood cell analysis for children (WS/T 779-2021)", these RIs may not suitable for small children all over the country due to racial, lifestyle, and geographical differences. The aim of this study was to establish and validate locally determined hematological reference intervals among young children in Nantong district and compare them with WS/T 779-2021 and American data.
Methods:
The reference sample consisted of 4,758 apparently healthy small children aged from age 28 days to 3 years according to the EP28-A3c guideline issued by the Clinical and Laboratory Standards Institute (CLSI). Capillary blood samples collected in K2-EDTA anticoagulant tubes analyzed by standard procedures. Statistical analysis was based on the guidelines of the CLSI.
Results:
Pediatric reference intervals for 18 capillary complete blood count (CCBC) parameters were established for young children. WBC and differentials did not differ by gender in the combined analysis of all data, but showed some variations among different age groups, especially for NE and LYM. RIs of RBC value, MCV, and MCH were established, especially with regard to the difference among different age and gender groups. An overall increasing trend of PLT value was observed in children with no obvious difference between boys and girls. Further validation with 1,136 healthy subjects demonstrated that the verified proportions of our study were within 90.11% - 100%. RIs determined in the present study were more concentrated than WS/T 779-2021, with slight differences in the upper and bottom boundaries.
Conclusions:
Establishing appropriate region-specific reference intervals for pediatrics is essential. This study offers local reference intervals of CCBC values for young children and could be used as a benchmark for similar populations in the Yangtze River Delta economic region.
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