Hematological Parameters after One Week of Life among Premature Neonates

Document Type : Original Article


1 Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Central General Hospital, Jl. Pasteur No. 38, Bandung, Indonesia

2 Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Indonesia, Jalan Eyckman No. 38., Bandung, Indonesia

3 Department of Clinical Pathology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin Central General Hospital, Jl. Pasteur No. 38, Bandung, Indonesia

4 Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Jalan Eyckman No. 38, Bandung, Indonesia


Background: Hematological parameters can reflect potential morbidity in premature neonates. Complete blood count (CBC) is a common laboratory examination in neonatal wards, including hematological parameters. Changes may occur during the neonatal period due to gestational age (GA)-related physiological mechanisms. The purpose of this study was to examine CBC in premature neonates at birth and in the first week of life.
Methods: This prospective study was performed in the neonatal ward of a general hospital in Bandung, Indonesia. A total of 53 premature neonates, including 31 males and 22 females, classified as G1 (with 28-31 weeks of gestation) and G2 (with 32-34 weeks of gestation), were examined for CBC. The sequential blood samples of both cord blood at birth and peripheral venous blood in the first week of life (i.e., days 2-7) were drawn. The obtained data were analyzed based on the GA at birth and in the first week of life. The CBC at birth and in the first week of life were also compared.
Results: At birth, younger premature neonates (i.e., G1 group) showed lower platelet counts, compared to the older ones (i.e., G2 group). In the first week of life, the G1 group showed significantly lower platelet counts and eosinophil counts, compared to the G2 group. Both groups demonstrated a significant decrease in hemoglobin, leukocytes, basophils, and neutrophils, but increased platelet counts in the first week of life.
Conclusion: Younger premature neonates indicated lower hematological parameters at birth and in the first week of life. All the premature neonates showed a significant reduction in most hematological parameters in the first week of life.


1. Blencowe H, Cousens S, Chou D, Oestergaard M, Say L, Moller AB, et al. Born too soon: the global epidemiology of 15 million preterm births. Reprod Health. 2013; 10(Suppl 1): S2.
2. Melville JM, Moss TJ. The immune consequences of preterm birth. Front Neurosci. 2013; 7:79.
3. Roudil P, Vasselon C, Trombert-Paviot B, Berger C, Patural H. Blood parameters of preterm neonates: postnatal evolution according to gestational age. Int J Lab Hematol. 2017; 39(3):317-28.
4. Holme N, Chetcuti P. The pathophysiology of respiratory distress syndrome in neonates. Paediatr Child Health. 2012; 22(12):507-12.
5. Hermansen CL, Lorah KN. Respiratory distress in the newborn. Am Fam Physician. 2007; 76(7):987-94.
6. Tollner U. Early diagnosis of septicemia in the newborn. Clinical studies and sepsis score. Eur J Pediatr. 1982; 138(4):331-7.
7. Topçu HO, Güzel Aİ, Özgü E, Yıldız Y, Erkaya S, Uygur D. Birth weight for gestational age: A reference study in a tertiary referral hospital in the middle region of Turkey. J Chin Med Assoc. 2014; 77(11):578-82.
8. Simonsen KA, Anderson-Berry AL, Delair SF, Davies HD. Early-onset neonatal sepsis. Clin Microbiol Rev. 2014; 27(1):21-47.
9. Gallacher DJ, Hart K, Kotecha S. Common respiratory conditions of the newborn. Breathe. 2016; 12(1): 30-42.
10. Christensen RD, Del Vecchio A, Henry E. Expected erythrocyte, platelet and neutrophil values for term and preterm neonates. J Matern Fetal Neonatal Med. 2012; 25(Suppl 5):77-9.
11. Esiaba I, Mousselli I, Faison GM, Angeles DM, Boskovic DS. Platelets in the Newborn. Neonatal Med. 2019; 2:86715.
12. Christensen RD, Henry E, Jopling J, Wiedmeier SE. The CBC: reference ranges for neonates. Semin Perinatol. 2009; 33(1):3-11.
13. Correa-Rocha R, Pérez A, Lorente R, Ferrando-Martinez S, Leal M, Gurbindo D, et al. Preterm neonates show marked leukopenia and lymphopenia that are associated with increased regulatory T-cell values and diminished IL-7. Pediatr Res. 2012; 71:590-7.
14. Carr R. Neutrophil production and function in newborn infants. Br J Haematol. 2000; 110(1):18-28.
15. Mouna K, Doddagowda SM, Junjegowda K, Krishnamurthy L. Changes in haematological parameters in newborns born to preeclamptic mothers - a case control study in a rural hospital. J Clin Diagn Res. 2017; 11(7):EC26-9.
16. Jopling J, Henry E, Wiedmeier SE, Christensen RD. Reference ranges for hematocrit and blood hemoglobin concentration during the neonatal period: data from a multihospital health care system. Pediatrics. 2009; 123(2): e333-7.
17. Strauss RG. Anaemia of prematurity: pathophysiology and treatment. Blood Rev. 2010; 24(6):221-5.
18. Widness JA. Pathophysiology of anemia during the neonatal period, including anemia of prematurity.
Neoreviews. 2008; 9(11): e520.
19. Juul SE, Haynes JW, McPherson RJ. Evaluation of eosinophilia in hospitalized preterm infants. J Perinatol. 2005; 25(3):182-8.
20. Nittala S, Subbarao GC, Maheshwari A. Evaluation of neutropenia and neutrophilia in preterm infants. J Matern Fetal Neonatal Med. 2012; 25(Suppl 5): 100-3.