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Neonatal hematological parameters: the translational aspect of developmental hematopoiesis

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Abstract

Hematopoiesis is a process constantly evolving from fetal life through adulthood. Neonates present with qualitative and quantitative differences in hematological parameters compared to older children and adults, reflecting developmental changes in hematopoiesis correlated with gestational age. Such differences are more intense for preterm and small-for-gestational-age neonates or neonates with intrauterine growth restriction. This review article is aimed at describing the hematologic differences among neonatal subgroups and the major underlying pathogenic mechanisms. Issues that should be taken into account when interpreting neonatal hematological parameters are also highlighted.

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References

  1. Esan AJ (2016) Hematological differences in newborn and aging: a review study. Hematol Transfus Int J 3(3):178–190. https://doi.org/10.15406/htij.2016.03.00067

    Article  Google Scholar 

  2. Christensen RD (2018) Hematology and immunology of newborns: overview. In: Buonocore G, Bracci R, Weindling M (eds) Neonatology: a practical approach to neonatal diseases. Springer International Publishing, Cham, pp 1405–1430

    Google Scholar 

  3. (WHO) W.H.O. Preterm birth. 20 October 2022]; Available from: https://www.who.int/news-room/fact-sheets/detail/preterm-birth#:~:text=Preterm%20is%20defined%20as%20babies,32%20to%2037%20weeks).%20Authors%20replay. Accessed 20 Oct 2022

  4. Battaglia FC, Lubchenco LO (1967) A practical classification of newborn infants by weight and gestational age. J Pediatr 71(2):159–163

    CAS  PubMed  Google Scholar 

  5. Diderholm B (2009) Perinatal energy metabolism with reference to IUGR & SGA: studies in pregnant women & newborn infants. Indian J Med Res 130(5):612–617

    CAS  PubMed  Google Scholar 

  6. American College of Obstetricians and Gynecologists (2001) Intrauterine growth restriction. Clinical management guidelines for obstetrician-gynecologists. Int J Gynaecol Obstet 72(1):85–96

    Google Scholar 

  7. Demicheva E, Crispi F (2014) Long-term follow-up of intrauterine growth restriction: cardiovascular disorders. Fetal Diagn Ther 36(2):143–153

    PubMed  Google Scholar 

  8. Widness JA (2008) Pathophysiology of anemia during the neonatal period, including anemia of prematurity. NeoReviews 9(11):e520–e520

    PubMed  PubMed Central  Google Scholar 

  9. Zipursky A et al (1983) The erythrocyte differential count in newborn infants. Am J Pediatr Hematol Oncol 5(1):45–51

    CAS  PubMed  Google Scholar 

  10. Christensen RD et al (2008) The erythrocyte indices of neonates, defined using data from over 12,000 patients in a multihospital health care system. J Perinatol 28(1):24–28

    CAS  PubMed  Google Scholar 

  11. Matoth Y, Zaizov R, Varsano I (1971) Postnatal changes in some red cell parameters. Acta Paediatr Scand 60(3):317–323

    CAS  PubMed  Google Scholar 

  12. Christensen RD et al (2016) Reference intervals for reticulocyte parameters of infants during their first 90 days after birth. J Perinatol 36(1):61–66

    CAS  PubMed  Google Scholar 

  13. Bedrick AD (2014) Nucleated red blood cells and fetal hypoxia: a biologic marker whose ‘timing’ has come? J Perinatol 34(2):85–86

    CAS  PubMed  Google Scholar 

  14. Elahi S (2019) Neglected cells: immunomodulatory roles of CD71(+) erythroid cells. Trends Immunol 40(3):181–185

    CAS  PubMed  Google Scholar 

  15. Palis J, Segel GB (1998) Developmental biology of erythropoiesis. Blood Rev 12(2):106–114

    CAS  PubMed  Google Scholar 

  16. Strauss RG (2010) Anaemia of prematurity: pathophysiology and treatment. Blood Rev 24(6):221–225

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Franz AR et al (2020) Effects of liberal vs restrictive transfusion thresholds on survival and neurocognitive outcomes in extremely low-birth-weight infants: the ETTNO randomized clinical trial. JAMA 324(6):560–570

    PubMed  Google Scholar 

  18. Manapurath RM et al (2022) Enteral iron supplementation in preterm or low birth weight infants: a systematic review and meta-analysis. Pediatrics 150(Suppl 1):e2022057092I. https://doi.org/10.1542/peds.2022-057092I

  19. Del Vecchio A, Motta M, Romagnoli C (2015) Neonatal platelet function. Clin Perinatol 42(3):625–638

    PubMed  Google Scholar 

  20. Kuhne T, Imbach P (1998) Neonatal platelet physiology and pathophysiology. Eur J Pediatr 157(2):87–94

    CAS  PubMed  Google Scholar 

  21. Sola-Visner M (2012) Platelets in the neonatal period: developmental differences in platelet production, function, and hemostasis and the potential impact of therapies. Hematology Am Soc Hematol Educ Program 2012:506–511

    PubMed  Google Scholar 

  22. Wiedmeier SE et al (2009) Platelet reference ranges for neonates, defined using data from over 47,000 patients in a multihospital healthcare system. J Perinatol 29(2):130–136

    CAS  PubMed  Google Scholar 

  23. Curley A et al (2018) Randomized trial of platelet-transfusion thresholds in neonates. N Engl J Med 380(3):242–251

    PubMed  Google Scholar 

  24. MacQueen BC et al (2017) The immature platelet fraction: creating neonatal reference intervals and using these to categorize neonatal thrombocytopenias. J Perinatol 37(7):834–838

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Manroe BL et al (1979) The neonatal blood count in health and disease. I. Reference values for neutrophilic cells. J Pediatr 95(1):89–98

    CAS  PubMed  Google Scholar 

  26. Schmutz N et al (2008) Expected ranges for blood neutrophil concentrations of neonates: the Manroe and Mouzinho charts revisited. J Perinatol 28(4):275–281

    CAS  PubMed  Google Scholar 

  27. Christensen RD (1987) Circulating pluripotent hematopoietic progenitor cells in neonates. J Pediatr 110(4):623–625

    CAS  PubMed  Google Scholar 

  28. Lawrence SM, Corriden R, Nizet V (2017) Age-appropriate functions and dysfunctions of the neonatal neutrophil. Front Pediatr 5:23

    PubMed  PubMed Central  Google Scholar 

  29. Medoff HS, Barbero GJ (1950) Total blood eosinophil counts in the newborn period. Pediatrics 6(5):737–742

    CAS  PubMed  Google Scholar 

  30. Xanthou M (1972) Leucocyte blood picture in ill newborn babies. Arch Dis Child 47(255):741–746

    CAS  PubMed  PubMed Central  Google Scholar 

  31. Christensen RD et al (2010) Reference ranges for blood concentrations of eosinophils and monocytes during the neonatal period defined from over 63 000 records in a multihospital health-care system. J Perinatol 30(8):540–545

    CAS  PubMed  Google Scholar 

  32. Burrell JM (1952) A comparative study of the circulating eosinophil level in babies. Arch Dis Child 27(134):337

    CAS  PubMed  PubMed Central  Google Scholar 

  33. Bass DA (1975) Behavior of eosinophil leukocytes in acute inflammation. II. Eosinophil dynamics during acute inflammation. J Clin Investig 56(4):870–879

    CAS  PubMed  PubMed Central  Google Scholar 

  34. Christensen RD, Rothstein G (1979) Pitfalls in the interpretation of leukocyte counts of newborn infants. Am J Clin Pathol 72(4):608–611

    CAS  PubMed  Google Scholar 

  35. Chervenick PA et al (1968) Quantitative studies of blood and bone marrow neutrophils in normal mice. Am J Physiol 215(2):353–360

    CAS  PubMed  Google Scholar 

  36. Köstlin-Gille N, Gille C (2020) Myeloid-derived suppressor cells in pregnancy and the neonatal period. Front Immunol 11:584712

    PubMed  PubMed Central  Google Scholar 

  37. Carr R (2000) Neutrophil production and function in newborn infants. Br J Haematol 110(1):18–28

    CAS  PubMed  Google Scholar 

  38. Wolach B et al (1998) Neonatal neutrophil inflammatory responses: parallel studies of light scattering, cell polarization, chemotaxis, superoxide release, and bactericidal activity. Am J Hematol 58(1):8–15

    CAS  PubMed  Google Scholar 

  39. Anderson DC et al (1990) Impaired transendothelial migration by neonatal neutrophils: abnormalities of Mac-1 (CD11b/CD18)-dependent adherence reactions. Blood 76(12):2613–2621

    CAS  PubMed  Google Scholar 

  40. Lorant DE et al (1999) P-selectin expression by endothelial cells is decreased in neonatal rats and human premature infants. Blood 94(2):600–609

    CAS  PubMed  Google Scholar 

  41. Imanirad P, Dzierzak E (2013) Hypoxia and HIFs in regulating the development of the hematopoietic system. Blood Cells Mol Dis 51(4):256–263

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Ozbek N, Gürakan B, Kayiran SM (2000) Complete blood cell counts in capillary and venous blood of healthy term newborns. Acta Haematol 103(4):226–228

    CAS  PubMed  Google Scholar 

  43. Proytcheva MA (2009) Issues in neonatal cellular analysis. Am J Clin Pathol 131(4):560–573

    PubMed  Google Scholar 

  44. Rolim ACB et al (2019) Blood cells profile in umbilical cord of late preterm and term newborns. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo 37(3):264–274

    PubMed  Google Scholar 

  45. Reibel NJ et al (2021) Aberrant hematopoiesis and morbidity in extremely preterm infants with intrauterine growth restriction. Front Pediatr 9

  46. Black LV, Maheshwari A (2009) Disorders of the fetomaternal unit: hematologic manifestations in the fetus and neonate. Semin Perinatol 33(1):12–19

    PubMed  PubMed Central  Google Scholar 

  47. Reibel NJ et al (2021) Aberrant hematopoiesis and morbidity in extremely preterm infants with intrauterine growth restriction. Front Pediatr 9:728607

    PubMed  PubMed Central  Google Scholar 

  48. Fustolo-Gunnink SF et al (2016) Early-onset thrombocytopenia in small-for-gestational-age neonates: a retrospective cohort study. PLoS ONE 11(5):e0154853

    CAS  PubMed  PubMed Central  Google Scholar 

  49. Yuko S et al (2013) Examination of the percentage of immature platelet fraction in term and preterm infants at birth. J Clin Neonatol 2(4):173–178

    PubMed  PubMed Central  Google Scholar 

  50. Tröger B et al (2013) Intrauterine growth restriction and the innate immune system in preterm infants of ≤32 weeks gestation. Neonatology 103(3):199–204

    PubMed  Google Scholar 

  51. Wirbelauer J et al (2010) Intrauterine growth retardation in preterm infants ≤32 weeks of gestation is associated with low white blood cell counts. Am J Perinatol 27(10):819–824

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, “Agios Panteleimon” General Hospital of Nikea, 3 D. Mantouvalou Str., 18454, Nikea, Piraeus, Greece

    Rozeta Sokou, Stavroula Parastatidou, Aikaterini Konstantinidi & Georgios Ioakeimidis

  2. Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 12462, Athens, Greece

    Andreas G. Tsantes, Dimitra Houhoula & Argirios E. Tsantes

  3. Neonatal Department, Medical School, Aretaieio Hospital, National and Kapodistrian University of Athens, 11528, Athens, Greece

    Nicoletta Iacovidou

Authors
  1. Rozeta Sokou
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  2. Stavroula Parastatidou
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  3. Aikaterini Konstantinidi
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  4. Georgios Ioakeimidis
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  5. Andreas G. Tsantes
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  6. Dimitra Houhoula
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  7. Nicoletta Iacovidou
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  8. Argirios E. Tsantes
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Correspondence to Rozeta Sokou.

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Sokou, R., Parastatidou, S., Konstantinidi, A. et al. Neonatal hematological parameters: the translational aspect of developmental hematopoiesis. Ann Hematol 102, 707–714 (2023). https://doi.org/10.1007/s00277-023-05144-2

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  • DOI: https://doi.org/10.1007/s00277-023-05144-2

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