Umbilical Cord Blood as an Alternative to Neonatal Blood for Complete Blood Count: A Comparison Study

L E Heeger; M I J Koster; C Caram-Deelder; V Bekker; J G van der Bom; E Lopriore

doi:10.1016/j.jpeds.2024.114059

Umbilical Cord Blood as an Alternative to Neonatal Blood for Complete Blood Count: A Comparison Study

J Pediatr. 2024 Apr 16:114059. doi: 10.1016/j.jpeds.2024.114059. Online ahead of print.

Authors

L E Heeger¹, M I J Koster², C Caram-Deelder³, V Bekker², J G van der Bom³, E Lopriore⁴

Affiliations

¹ Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands; Sanquin Blood Supply Foundation, Clinical Center for Transfusion Research, Amsterdam, The Netherlands.
² Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands.
³ Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
⁴ Willem-Alexander Children's Hospital, Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: e.lopriore@lumc.nl.

PMID: 38636783
DOI: 10.1016/j.jpeds.2024.114059

Abstract

Objective: To assess concordance between umbilical cord blood (UCB) and neonatal blood (NB) laboratory test results at birth.

Study design: This retrospective study considered very preterm neonates (<32 weeks' gestational age) admitted to a tertiary neonatal intensive care unit from 2012 to 2023. Inclusion criteria required neonates with a complete blood count measured in both UCB and NB drawn within 2 hours after birth. Median hemoglobin (Hb) and hematocrit (Hct) concentrations were compared between UCB (venous samples) and NB (venous, arterial, or capillary samples).

Results: A total of 432 neonates with paired UCB and NB values were included in the study. Hb concentration in UCB was 14.7 g/dL (interquartile range [IQR] 13.5-16.1 g/dL) compared with 14.8 g/dL (IQR 12.6-19.3 g/dL) in venous NB samples, 13.9 g/dL (IQR 12.9-15.3 g/dL) in arterial NB and 18.7 g/dL (IQR 16.6-20.8 g/dL) in capillary NB. The regression equation showed a correction factor of 1.08 for converting Hb values from UCB to venous NB. Median Hct concentration in UCB was 0.45 L/L (IQR: 0.41-0.49 L/L) compared with 0.48 L/L (IQR 0.43-0.54 L/L) in venous NB, 0.42 L/L (IQR 0.38-0.45 L/L) in arterial NB and 0.57 L/L, (IQR 0.51-0.63 L/L) in capillary NB.

Conclusions: Hb and Hct concentrations measured in UCB are similar to those measured in venous blood in very preterm infants and are valid alternatives for NB tests at birth. Hb and Hct concentrations in arterial and capillary NB are respectively lower and higher compared with UCB measurements.

Keywords: anemia of prematurity; cord blood sampling; iatrogenic blood loss; neonatal intensive care unit; preterm neonates; red blood cell transfusion.