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Updated: Sep 12, 2025

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The Role of Extended New Red Blood Cell Parameters on the First Day of Moderate to High-Risk Newborns
Aslıhan Çomruk1, Zühre Kaya1, Serap Kirkiz Kayalı1
1Department of Pediatric Hematology, Faculty of Medicine, Gazi University, Ankara, Turkey.
Abstract:
The extended erythrocyte parameters in modern hematology analyzers on the first day of moderate to high-risk newborns in the neonatal intensive care unit (NICU) were examined. The Turkish Neonatal Society's risk classifications were used to divide the newborns into 2 groups: moderate to high-risk (n = 266) and low-risk (n = 340). Routine and extended erythrocyte parameters were analyzed. Moderate to high-risk neonates had significantly lower mean hemoglobin and higher mean corpuscular volume (MCV) and macrocytic erythrocyte ratios (MACRO-R) compared with low-risk newborns (p < .05). Preterm birth, sepsis, pulmonary complications, maternal preeclampsia, and hyperbilirubinemia were all common in moderate to high-risk newborns. A strong correlation was found between MCV and MACRO-R (r = 0.91). The cut-off values for MCV and MACRO-R in predicting moderate to high-risk newborns were 110 fL and 20%, respectively. Our data suggest that increased MCV and MACRO-R levels may be useful predictors of moderate to high-risk newborns on their first day in the NICU.
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