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Towards improved neonatal care: Developing reference intervals for biochemical parameters in umbilical cord blood: An
Keyur Sabnis1, Swati Ghanghurde2, Akash Shukla1
1III YR MBBS Student, Rajiv Gandhi Medical College, Thane 400605, Maharashtra, India.
Insights
This study establishes crucial biochemical reference intervals for newborn cord blood in Mumbai, India. These new reference ranges aid in accurate interpretation of laboratory data for clinical decisions in the region.
Area of Science:
- Biochemistry
- Neonatal Medicine
- Clinical Pathology
Background:
- Biochemical parameter reference ranges vary with factors like altitude, age, gender, and socioeconomic status.
- Accurate reference intervals are vital for interpreting laboratory data and guiding clinical treatment.
- No established reference intervals exist for cord blood biochemical parameters in Indian newborns, especially in Mumbai.
Purpose of the Study:
- To establish specific reference intervals for cord blood biochemical parameters in newborns from Mumbai, India.
- To provide a foundational dataset for neonatal healthcare providers in the region.
Main Methods:
- A cross-sectional study involving 210 healthy term neonates in a tertiary care hospital.
- Cord blood samples were collected and analyzed for various biochemical parameters.
- Non-parametric statistical methods were used due to non-normal data distribution, with Mann-Whitney U test for comparisons.
Main Results:
- Median values and 95% reference intervals were determined for serum bilirubin, creatinine, sodium, chloride, potassium, and plasma glucose.
- Statistically significant differences in serum sodium, potassium, and plasma glucose were noted based on delivery mode.
- Established reference intervals: Serum direct bilirubin (0.1-0.55) mg/dL, creatinine (0.27-0.76) mg/dL, sodium (128.19-143.26) mmol/L, plasma glucose (24.75-94.23) mg/dL.
Conclusions:
- This study presents the first biochemical reference intervals for newborn cord blood in Western India.
- The established values are specific to newborns in the Mumbai region.
- Further nationwide studies are recommended to broaden the applicability of these findings.
Background:
The reference ranges for biochemical parameters can fluctuate due to factors like altitude, age, gender, and socioeconomic conditions. These values are crucial for interpreting laboratory data and guide clinical treatment decisions. Currently, there is no established set of reference intervals for cord blood biochemical parameters of newborns in India, particularly in Mumbai.
Aim:
To create cord blood biochemical parameters reference intervals specifically for Mumbai, India.
Methods:
A cross-sectional study was conducted in an Indian tertiary care hospital. This study focused on healthy newborns with normal birth weight, born to pregnant mothers without health issues. Cord blood samples, approximately 2-3 mL in volume, were collected from 210 term neonates. These samples were divided into fluoride (glucose) and clot activator (serum) tubes and were subsequently analyzed in the institute's biochemical laboratory. The data obtained from the analysis was then subjected to statistical analysis. The result of the Shapiro-Wilk test suggested non-normality in the data distribution. Consequently, non-parametric statistics were utilized for analysis. The Mann-Whitney U test was utilized to compare parameter distributions among different factors, including the infant's sex, delivery method, maternal age, and obstetric history. A significance level of P < 0.05 was considered to indicate statistical significance.
Results:
The following represent the median figures and central 95 percentile reference intervals for biochemical parameters in umbilical cord blood of newborns: Serum direct bilirubin = (0.1-0.55) mg/dL, indirect bilirubin = (0.64-2.26) mg/dL, total bilirubin = (0.62-3.14) mg/dL, creatinine = (0.27-0.76) mg/dL, sodium = (128.19-143.26) mmol/L, chloride = (100.19-111.68) mmol/L, potassium = (1.62-9.98) mmol/L and plasma glucose = (24.75-94.23) mg/dL. Statistically significant differences were observed in serum sodium, potassium, and plasma glucose levels when comparing delivery modes.
Conclusion:
This is the pioneering study in which first time, the biochemical reference intervals in cord blood for newborns are established in western India. The values are applicable for newborns from this area. Larger study throughout the country is required.
