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Korean Journal of Obstetrics & Gynecology 2004;47(1):68-75.
Published online January 1, 2004.
Evaluation of NeonatalImmature Reticulocyte Fraction in Small-for-gestational Age Infant in Umbilical Cord Blood.
Woong Sun Kang, Yong Kyoon Cho, Ji Kyung Ko, Kee Hyun Park, Myoung Hwan Kim, Chul Min Lee, Tae Hee Han, Hoon Choi, Bok Rin Kim, Hong Kyoon Lee
1Department of Obstetrics and Gynecology, Colleage of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea.
2Department of Clinical Pathology, Colleage of Medicine, Inje University, Sanggye Paik Hospital, Seoul, Korea.
Abstract
OBJECTIVE
To evaluate the immature reticulocyte fraction (IRF) by automated calculator that have played a role of predicting marker for hematopoiesis induced by perinatal asphyxia. METHODS: Hospital charts of 40 neonates with diagnosis of small for gestational age (SGA: birth weight <10 percentile) and 47 babies of appropriate for gestational age (AGA) who were delivered vaginally between May 8, 2000 and March 2, 2002 at department of Obstetric and Gynecology, Sanggye Paik Hospital, Inje university. About 5 cc in cord blood was collected immediately after delivery, the calculation of nucleated RBC (N-RBC)/100WBC by macroscopic exam and the evaluation of reticulocyte maturation by automated reticulocyte calculator (Sysmex SE 9000, TOA Medical Electronics Co., Ltd, Kobe, Japan) were performed, and made a comparative study of apgar score. RESULTS: The comparison between AGA and SGA infants, the mean values of cord blood sampling parameter N-RBC (3.53 +/- 4.89 vs 7.92 +/- 10.06, P=0.016), middle fluorescence ratio reticulocyte (MFR) (0.21 +/- 0.02 vs 0.23 +/- 0.03, P<0.001), high fluorescence ratio reticulocyte (HFR) (0.08 +/- 0.03 vs 0.12 +/- 0.03, P<0.001), IRF (0.28 +/- 0.03 vs 0.35 +/- 0.05, P<0.001) were obtained. All of the parameters were significantly different between SGA infants and normal infants and IRF was more valuable marker than N-RBC in evaluation of hematopoietic activity in SGA infants (multiple logistic regression analysis: P value 0.282 vs <0.001). CONCLUSION: Immature reticulocyte fraction by automated calculator is more accurate and confident marker better than N-RBC/100WBC by manual countingin evaluation of the fetal hypoxic induced hematopoiesis.
Key Words: Hematopoiesis, Nucleated RBC, Immature reticulocyte fraction, Small-for-gestational age
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