Peripheral leukocyte count and leukocyte indexes in healthy newborn term infants☆,☆☆
Section snippets
METHODS
One hundred ninety-three consecutive healthy term-gestation neonates born at Wilford Hall Medical Center were enrolled in the study during the months of February to July 1993. A healthy neonate was defined as one without maternal, intrapartum, or neonatal complications that would give rise to the clinical suspicion of sepsis. Exclusion criteria included neonates born at less than 36 weeks of gestation, admission to the neonatal intensive care unit, proven sepsis or congenital pneumonia,
RESULTS
Table II lists the mean (±SD) and the 10% to 90% range for the leukocyte indexes in our population of healthy neonates at 4 hours of age. Though we report a 10% lower limit for the I/T and I/M ratios and the total immature forms, we recognize that a value of zero is also normal. Neutropenia, <1.5 × 109/L (1500/mm3) segmented and band neutrophils, was not present in any study patient.
Birth weight, sex, ethnicity, gestational age, maternal complications, intrapartum complications, umbilical
DISCUSSION
Numerous reports have suggested that neutrophil indexes, particularly the I/T ratio and the absolute neutrophil count, are useful predictors of sepsis in neonates.1, 2, 3, 4, 5, 6, 7, 8, 9, 10 The most comprehensive study was published in 1979 by Manroe et al.,9 who examined 585 peripheral smears from 304 neonates during the first 28 days of life to establish reference values for neutrophilic cells. The maximum normal I/T proportion found in that study was 0.16, but a relatively small number of
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Cited by (74)
Newborn Sepsis and Meningitis
2018, Avery's Diseases of the Newborn: Tenth EditionNewborn Sepsis and Meningitis
2017, Avery's Diseases of the Newborn, Tenth EditionHematology Analyzers. Special Considerations for Pediatric Patients.
2015, Clinics in Laboratory MedicineCitation Excerpt :Knowledge of how analytical and postanalytical issues can influence test results is also important. A variety of instruments have been used to obtain blood counts in healthy children or children with disease; these instruments included Sysmex instruments (NE 8000, SE-9500, and XE-2100; Sysmex, Tokyo, Japan),3,28,30–32 Coulter instruments (Beckman Coulter, Brea, CA, USA),33–35 Abbott instruments (Cell-Dyn series; Abbott Diagnostics, Abbott Park, IL, USA),9,36 and Siemens instruments (Advia series; Siemens Medical Solutions, Malvern, PA, USA).3,28,30–32 However, most of the reports have focused on measured or calculated hematologic indices and do not discuss strengths and limitations of the instruments when used in the evaluation of pediatric (especially neonatal) blood samples.
Soluble ecto-5'-nucleotidase (5'-NT), alkaline phosphatase, and adenosine deaminase (ADA1) activities in neonatal blood favor elevated extracellular adenosine
2013, Journal of Biological ChemistryCitation Excerpt :Upon incubation with 100 μm MLS-0038949, 100 μm APCP, or both and 50 μm [14C]AMP, newborn hemocytes demonstrated a significantly higher conversion of AMP to adenosine than adult hemocytes (Fig. 3). Experiments were performed at volumetric equivalence (i.e. not at equivalent cell numbers), and differences in cell density, known to be higher in newborn blood (42), probably contribute to observed differences in purine metabolism. Surprisingly, AP was responsible for a slight majority of newborn hemocyte-associated AMPase activity, with 5′-NT responsible for the remainder (Fig. 3, A and C).
Physical examination instead of laboratory tests for most infants born to mothers colonized with group B streptococcus: Support for the centers for disease control and prevention's 2010 recommendations
2013, Journal of PediatricsCitation Excerpt :In 220 neonates with suspected early onset sepsis, the sensitivity of WBC and immature/total neutrophil ratio was 46%.9 The insufficient sensitivity and low positive predictive value of CBC in the identification of infected but asymptomatic infants was confirmed further in other studies.15 CRP is already known to be of limited value at the time of the initial evaluation of infants with suspected sepsis,14,16 and is not included in the sepsis work-up recommended by the CDC.
A Practical Approach to the Neutropenic Neonate
2012, Hematology, Immunology and Infectious Disease: Neonatology Questions and Controversies
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From the Departments of Pediatrics and Pathology, Wilford Hall United States Air Force Medical Center, Lackland Air Force Base, Texas
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Reprint requests: Robert L. Schelonka, MD, Department of Pediatrics, Wilford Hall Medical Center/PSP, 2200 Bergquist Dr. STE 1, Lackland AFB, TX 78236-5300.