Establishing Reference Intervals for Comprehensive Metabolic Panel Analytes in Cord Blood and Infants

Tuesday, April 24, 2012
E: Andrija Stampar Hall (Millennium Hall)
Mulugeta Melkie Arbaminch University, Ethiopia
Samuel Kinde Addis Ababa University, Ethiopia
Tilahun Teka Addis Ababa University
Mahlet Yigeremu Addis Ababa University
Paulos Nigussie Ethiopian Health and Nutrition Research Institute
Tatek G/egziabher Black Lion Hospital
Shawel Asrat Addis Ababa University
Background: Age and gender specific reference intervals (RIs) are crucial for screening, diagnosis and monitoring of many pediatric diseases and disorders. However, the existing RIs of comprehensive metabolic panel (CMP) analytes may not be used for Ethiopian pediatric population in one or another way since the intervals were established mainly for Caucasian population.

Objective: This study is aimed to establish RIs for CMP analytes in cord blood and infants.

Materials/Methods: A total of 117 infants and newborns were included from Teklehaymanot Health Center and Tikur Anbessa Specialized Hospital. Cord blood samples and venous blood samples were collected and analyzed using HumaStar300 and AVL (9181) ISE analyzer from December 2010 to April 2011. A robust, CLSI/ IFCC recommended, method was used for the determination of upper and lower end points of RIs of each analyte with respective 90% CI using MedCalc® software.

Result: Combined RIs for newborns and infants were established for albumin, AST, ALP, DB, TB, creatinine, urea, Na+, K+ and Cl- to be  3.88-5.82g/dl, 16.1-55.4U/l, 130-831U/l, <0.41mg/dl, <1.37mg/dl, 0.05-1.64mg/dl, 3-25.1mg/dl, 126-143mmol/l, 4.01-7.9mmol/l and 99.7-111mmol/l respectively. But, separated RIs were indicated for glucose, TP, ALT and GGT as 38.8-118.8mg/dl and 48.9-97.3mg/dl glucose, 4.38-8.67g/dl and 5.99-7.91g/dl TP, 1.2-23.1U/l and 6.94-24.8U/l ALT; and 30.6-160.7U/L and 10-28.2U/l GGT for newborns and infants respectively. Some maternal, neonatal and infantile factors were identified to affect values of analytes.

Conclusion/recommendations: Almost all analytes were completely different from previously reported values for other target population of similar age group; text book and kit insert values. These values were also different from the ones provided for adult populations. Therefore, interpretation of values of these analytes in newborns and infants of Ethiopian population sounds better to be performed by these RIs taking the effect of maternal, neonatal and infantile factors on the values of analytes in to account.


Learning Objectives: 1. show reference intervals of biochemical analytes in cord blood and infants in ethiopia 2. discuss the effect of some maternal, neonatal and infantile factors on the values of biochemical analytes in cord blood and infants 3. compare the established reference intervals with the available text book and manufacturer kit insert values
See more of: MDG 4 Child Health
See more of: Achieving Millennium Development Goals: Vital for Global Health Equity
Previous Abstract | Next Abstract >>