Journal
AMERICAN JOURNAL OF CLINICAL PATHOLOGY
Volume 131, Issue 4, Pages 560-573Publisher
AMER SOC CLINICAL PATHOLOGY
DOI: 10.1309/AJCPTHBJ4I4YGZQC
Keywords
Developmental hematopoiesis; Fetal blood; Hematologic values; Newborns; Neonates; Term; Preterm; Preanalytic factors; Analytic interference; Reference intervals
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Hematologic values in neonates differ significantly from those in older children and adults. Quantitative and qualitative differences are present as a reflection of the developmental changes during fetal hematopoiesis and, so, correlate with gestational age. At birth, the hemoglobin, mean corpuscular volume, and WBC counts of term newborns arc, significantly higher than those of older children and adults, and in preterm neonates the differences are even more pronounced This review explores these differences and the major factors that account for them from the hematology laboratoty standpoint. After a discussion of the developmental hematopoiesis and normal hematologic values in term and preterm neonates, important preanalytic factors, such as limited blood availability, effect of sampling site, and violent crying, and analytic interferences are examined Finally, the review addresses resulting challenges in interpretation of hematologic test results in term and preterm neonates, especially issues surrounding neonatal reference intervals and critical value reporting, and suggests possible solutions.
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