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Reference intervals for reticulocyte parameters of infants during their first 90 days after birth

Journal of Perinatology volume 36, pages 61–66 (2016)Cite this article

Subjects

Abstract

Objective:

The automated reticulocyte parameters (absolute reticulocyte count, immature reticulocyte fraction (IRF) and reticulocyte hemoglobin content (RET-He)) are of value in managing adults and older children with a variety of hematological disorders. However, the lack of reference intervals for these parameters in neonates and young infants has limited their application to that population.

Study Design:

During a span of 12 months (29 May 2014 to 5 May 2015), a convenience sample of reticulocyte parameters were run from clinically ordered complete blood counts (CBCs) of infants within the first 90 days after birth. Measuring the reticulocyte parameters as a research-only adjunct to the CBC did not require any additional blood or generate a patient charge, and the reticulocyte results were not reported to the provided and did not appear in the clinical records. Values from neonates who had a transfusion or a diagnosis of anemia were subsequently excluded from the reference data set.

Results:

Nine Intermountain Healthcare clinical laboratories contributed 8438 CBCs to the initial reticulocyte parameter database. From these, 1806 were excluded because of a transfusion or a diagnosis of anemia, leaving 6632 in the reference interval database. The parameters charted over the first 90 days after birth were: (1) blood hemoglobin concentration (g dl−1), (2) mean corpuscular volume (fL), (3) reticulocyte count (x103 per μl), (4) IRF (%) and (5) RET-He (pg).

Conclusions:

The new reference interval charts can help clinicians identify abnormalities in the reticulocyte parameters. This information could be of value in identifying and following neonates with various hematological problems including hemolytic disorders, occult hemorrhage, or iron deficiency or other limitations of erythrocyte production.

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Acknowledgements

We thank Dr Jolanta Kunicka, Elizabeth Wiet and Lance Kocherhans of the Sysmex America, and Dr Larry D Eggert, Intermountain Healthcare, for helpful discussions; Diane K Lambert, RN, Intermountain Healthcare, for assistance with IRB communications and laboratory staff members Robert Childs, Dereck Daniels, Rachael Ethington, Lauri Jeffs, Jennessa Jessop, Heather Kuusela, Chris Partington, Brooke Qi, Lauralyn Ragin, Aba Saunders, Alicia Simon, Thomas Taylor and Ashley Windsor for extracting data from the hematology analyzers. The study was supported by a research grant from Intermountain Research and Medical Foundation, Murray, Utah, 84157, USA.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    R D Christensen

  2. Women and Newborn’s Program, Intermountain Healthcare, Salt Lake City, UT, USA

    R D Christensen & E Henry

  3. Division of Hematology/Oncology, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT, USA

    R D Christensen & H M Yaish

  4. Institute for Healthcare Delivery Research, Salt Lake City, UT, USA

    E Henry

  5. Department of Pathology, Intermountain Medical Center, Murray, UT, USA

    S T Bennett

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  1. R D Christensen
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  4. H M Yaish
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Correspondence to R D Christensen.

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Christensen, R., Henry, E., Bennett, S. et al. Reference intervals for reticulocyte parameters of infants during their first 90 days after birth. J Perinatol 36, 61–66 (2016). https://doi.org/10.1038/jp.2015.140

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