Study of hemoglobin and red blood cell indices during first week of life in normal term neonates

Abstract

Background: Transition from foetal to neonatal life is associated with major changes in hemogram due to homeostatic control. There are very wide ranges of hemogram levels that seem to be abnormally high or low in healthy term neonate at birth and during first week of life but these were actually normal for that neonatal period depending upon gestational and post-natal age.

Method: Hemogram was studied in 100 normal term neonates born in RNT medical college during June 2009 to Dec 2009.

Results: The ranges of various hemogram indices at birth, 24 hours, 48 hours and 7 days are as follows: Hemoglobin 12.2-23.2 gm/dl, 11.6-22.8 gm/dl, 11.5-21.3 gm/dl and 11.3-21.3 gm/dl respectively. Hematocrit 36.8-64.3%, 35.2-61.3%, 34.4-60.6% and 32.2-60.1% respectively. Mean corpuscular volume (MCV) 82.2-126.5 fl, 82.5-126.1 fl, 82.1-126.3 fl and 80.5-126.4 fl respectively. Mean corpuscular hemoglobin (MCH) 26.2-40.9 pg, 26.0-39.7 pg, 26-40.5 pg and 25.4-39.4 pg respectively. MCH concentration (MCHC) 29.6-38 g/dl, 28.5-37.7 g/dl, 28.4-38.6 g/dl and 28.4-38.5 g/dl respectively. Total red blood cell count (TRBC) 3.7-6.9×10⁶/µl, 3.3-6.9×10⁶/µl, 3.3-6.7×10⁶/µl and 3.3-6.3×10⁶/µl respectively.

Conclusions: Hemoglobin level falls in early life in healthy term neonate. Also, there is wide range of RBC parameters in healthy term neonates. The normal values of hemogram in neonates are different from other age groups and it varies with postnatal age and gestational age. A reference range derived from large neonatal datasets of varied gestational and postnatal age should be used such as those presented here for healthy term neonates.