Evaluation of Hematological Values of Newborns Umbilical Cord Blood In Khartoum state

Abstract

This is cross-sectional descriptive and analytical study which is carried out in Khartoum state maternity hospitals to identify the values and different hematological parameters of cord blood, this include fetal hemoglobin, and their changes in relation to sex variation, , and maternal anemia, The major purpose of the study to evaluate the hematological values and hemoglobin F, coagulation test and mean levels of serum iron and serum ferritin in umbilical cord blood of Sudanese neonates at birth, and to identify the effects of maternal anemia, fetus gender on umbilical cord blood hematological mean values if any. Such study will provide valuable informative data for hematological profile of Sudanese neonatal cord blood under normal physiological status. 500 cord blood samples were enrolled, samples were collected in the Departments of Obstetrics and Gynecology at the Saudi Maternity Hospital and Midwives Maternity Hospital in Omdurman city, Khartoum and Khartoum North hospitals, by experienced midwives trained in cord blood collection; cord blood samples were collected from normal vaginal o deliveries before the placenta delivery. A needle was inserted into the umbilical vein above the clamp and blood was drained into the sterile collected plain, K2EDTA and citrate containers, at the time of delivery, informative demographic data on the type of delivery, sex, weight, gestational age, health conditions of the infant and mother were written in questionnaire. . The study revealed that hemoglobin mean value of healthy Sudanese cord blood at birth was 14.35±1.55gm/dl, a hematocrit mean value was 0.44 L/L ±5.14, MCV, MCH, and MCHC mean values were 105.5 ±5.14fl, 33.5±1.99pg and 33.1±1.19gm/dl respectively. Normal red cells morphology was seen. The study revealed that the mean values for red cell count of Sudanese cord blood was 4.43x1012/l ± 0.6, cord blood nRBCs count 2.3/100 WBCs ± 1.46, and absolute nRBCs count were 267.8x109/l ± 200. Total leukocyte count with mean value of 12.3 x 10 9/l ± 4.17 was observed at birth, the white blood cell differential count revealed neutrophilia rather than lymphocytosis at birth, mean values of neutrophil and lymphocyte absolute count were 5.6 x 10 9/l ± 0.991 and 3.97x109/l ± 0.964 respectively, the mean value of the platelet count in study group was261x109/l ± 83.16, higher count up to 491x 109/l was found. Overall reticulocyte counts in this study showed that, reticulocyt count 5.85%±1.2, corrected reticulocyte count 5.00±1.2, absolute reticulocyte count with mean of 247.7x109/l ± 69.19, and reticulocyte production index mean5.5±1.48, Cord blood hemoglobin electrophoresis patterns were of FA, Hb F values 61.9%±8.56, Hb A 37.1%±0.25, and Hb A2 0.14%±0.1, and cord blood Hb F demonstrated by Kaliehauer slide method showed predominate of fetal hemogolobin of neonatal red cells. First line coagulation tests show that prothrombin time mean value25±4.28seconds, APTT43.1±3.53 seconds, Thrombin time18.5±2.94 seconds and fibrinogen values 335.8± 45.61mg/dl were encountered. Umbilical cord blood serum iron mean value was found to be 142.9±50.9 μg/dl, serum ferritin mean value of 174.6μg/L±70.4 was observed. The study revealed there were higher reticulocyte counts in babies born to anemic mothers in comparison to babies born to non-anemic mothers with statistical significant level of (p value 0.05). No gender related differences for reticulocyte counts were observed. Hb F mean value significantly higher in cord blood obtained from babies born to anemic mothers in comparison to babies born to non anemic mothers (p <0.05), because high affinity of fetal hemogglobin should be provided by compensatory mechanism of neonatal hemopoiesis to overcome increased demand for oxygen in babies born to anemic mothers. In contrast Hb A significantly reduced in babies born to anemic mothers in comparison to babies born to non-anemic mothers, however no significant differences were found in mean values of Hb A2 between tow groups (p>0.05). No gender mean differences for Hb A, F, and A2 were found.