Seong Jin CHOİ, Saejin LEE, Byoungkook LEE, Jae Yun JANG, Jooyoung CHO, Young UH

Comparison of neonatal reference intervals for 23 biochemical analytes in the cord blood-A single center study in South Korea

Reference intervals for laboratory tests are important in the diagnosis andtreatment of disease. However, due to difficulty in recruiting sufficientnumbers of reference subjects, studies regarding reference intervals forbiochemical analytes in neonates is lacking. The aim of this study was tocompare and validate the reference intervals for 23 biochemical analytes inthe cord blood of neonates. From August to December 2017, 79 consecutiveneonates born at the Wonju Severance Christian Hospital (Wonju, Korea)with C-reactive protein concentration less than 0.05 mg/dL were includedin this study. All of 23 biochemical analytes were measured by the cobas8000 c702 (Roche Diagnostics, Switzerland). Mean ± 2 standard deviations(SD) were calculated if the values were normally distributed, and median andthe range of 2.5–97.5 percentile were described when the values were notnormally distributed. We compared the neonatal reference intervals for 23biochemical analytes. Alkaline phosphatase and gamma glutamyl transferaseshowed significant differences according to sex, and direct bilirubin revealedsignificant differences depending on the delivery mode. These comparedreference intervals of 23 biochemical analytes will be useful for clinicaldecision-making in the management of neonates.

PDF

___

1. Concordet D, Geffre A, Braun JP, Trumel C. A new approach for the determination of reference intervals from hospital-based data. Clin Chim Acta 2009; 405: 43-48.

2. Melioli G, Risso FM, Sannia A, et al. Reference values of blood cell counts in the first days of life. Front Biosci (Elite Ed) 2011; 3: 871-878.

3. Horowitz GL, Altaie S, Boyd JC, et al. EP28-A3c: Defining, establishing, and verifying reference intervals in the clinical laboratory; Approved guideline. (3rd ed). Wayne, PA: Clinical and Laboratory Standards Institute; 2010.

4. Alström T, Gräsbeck R, Lindblad B, Solberg HE, Winkel P, Viinikka L. Establishing reference values from adults: recommendation on procedures for the preparation of individuals, collection of blood, and handling and storage of specimens. Committee on Reference Values of the Scandinavian Society for Clinical Chemistry. Scand J Clin Lab Invest 1993; 53: 649-652.

5. Solberg HE, Gräsbeck R. Reference values. Adv Clin Chem 1989; 27: 1-79.

6. Schnabl K, Chan MK, Gong Y, Adeli K. Closing the gaps in paediatric reference intervals: the CALIPER initiative. Clin Biochem Rev 2008; 29: 89-96.

7. Jones G, Barker A. Reference intervals. Clin Biochem Rev 2008; 29(Suppl 1): S93-S97.

8. Siest G. Study of reference values and biological variation: a necessity and a model for Preventive Medicine Centers. Clin Chem Lab Med 2004; 42: 810-816.

9. Cho SM, Lee SG, Kim HS, Kim JH. Establishing pediatric reference intervals for 13 biochemical analytes derived from normal subjects in a pediatric endocrinology clinic in Korea. Clin Biochem 2014; 47: 268-271.

10. Aytekin M, Emerk K. Accurate reference intervals are required for accurate diagnosis and monitoring of patients. EJIFCC 2008; 19: 137-141.

11. Reed AH, Henry RJ, Mason WB. Influence of statistical method used on the resulting estimate of normal range. Clin Chem 1971; 17: 275-284.

12. Sinton TJ, Cowley DM, Bryant SJ. Reference intervals for calcium, phosphate, and alkaline phosphatase as derived on the basis of multichannel-analyzer profiles. Clin Chem 1986; 32(1 Pt 1): 76-79.

13. Lahti A. Partitioning biochemical reference data into subgroups: comparison of existing methods. Clin Chem Lab Med 2004; 42: 725-733.

14. Harris EK, Boyd JC. On dividing reference data into subgroups to produce separate reference ranges. Clin Chem 1990; 36: 265-270.

15. Ceriotti F. Establishing pediatric reference intervals: a challenging task. Clin Chem 2012; 58: 808-810.

16. Christensen RD, Henry E, Jopling J, Wiedmeier SE. The CBC: reference ranges for neonates. Semin Perinatol 2009; 33: 3-11.

17. Perkins SL, Livesey JF, Belcher J. Reference intervals for 21 clinical chemistry analytes in arterial and venous umbilical cord blood. Clin Chem 1993; 39: 1041-1044.

18. Rao R, Georgieff MK. Iron in fetal and neonatal nutrition. Semin Fetal Neonatal Med 2007; 12: 54-63.

19. Lee HR, Shin S, Yoon JH, Roh EY, Chang JY. Reference intervals of hematology and clinical chemistry analytes for 1-year-old Korean children. Ann Lab Med 2016; 36: 481-488.

20. Orakzai SA, Siddiqui KA, Ayub M, Saeed AK. Serum proteins in infants. J Pak Med Assoc 1987; 37: 251- 255.

21. Heiduk M, Page I, Kliem C, Abicht K, Klein G. Pediatric reference intervals determined in ambulatory and hospitalized children and juveniles. Clin Chim Acta 2009; 406: 156-161.

22. Fierabracci V, Franzini M, Baggiani A, et al. Developmental variations of plasma gammaglutamyltransferase fractions in humans and in laboratory mammalians. Biomarkers 2012; 17: 43-47.

23. Whitfield JB. Gamma glutamyl transferase. Crit Rev Clin Lab Sci 2001; 38: 263-355.

24. Kim DB, Lim G, Oh KW. Determination of reference range of gamma glutamyl transferase in the neonatal intensive care unit. J Matern Fetal Neonatal Med 2017; 30: 670-672.

25. Dolphin PJ, Breckenridge WC, Dolphin MA, Tan MH. The lipoproteins of human umbilical cord blood apolipoprotein and lipid levels. Atherosclerosis 1984; 51: 109-122.

26. Colantonio DA, Kyriakopoulou L, Chan MK, et al. Closing the gaps in pediatric laboratory reference intervals: a CALIPER database of 40 biochemical markers in a healthy and multiethnic population of children. Clin Chem 2012; 58: 854-868.