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CBC and differential in VLBW infants
1Cardinal Glennon Children's Hospital Neonatal Services, St. Louis, MO 63104, USA.
Neonatal Network : NN
|December 16, 1998
Summary
Established leukocyte indices are variable in preterm infants, making routine complete blood counts questionable. Mode of delivery impacts results, necessitating careful clinical interpretation for these neonates.
Area of Science:
- Neonatal Medicine
- Hematology
- Pediatrics
Background:
- Leukocyte indices are commonly used in neonatal care.
- Established reference ranges may not be adequate for extremely preterm infants.
Purpose of the Study:
- To evaluate the adequacy of standard leukocyte indices for infants with low birth weight (< or = 1,200 gm) and preterm gestation (< or = 32 weeks).
Main Methods:
- Retrospective chart review of 131 outborn infants admitted to the NICU within 24 hours of birth.
- Leukocyte indices were plotted over the first 72 hours of life.
Main Results:
- Total leukocyte count and absolute neutrophil count were significantly affected by the mode of delivery.
- Sex and prenatal steroid use did not influence these counts.
- Normal ranges for leukocyte count, absolute neutrophil count, and immature/total neutrophil (I:T) ratio are highly variable and change with time.
Conclusions:
- Normative data for leukocyte indices are difficult to apply in extremely preterm infants due to wide variability and influence of delivery mode.
- The clinical utility and appropriateness of routine complete blood counts in this population should be questioned.