Potential Substitution of Cord Blood for Infant Blood in the Neonatal Sepsis Evaluation

Vol. 88, No. 1, 2005

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Original Paper

Potential Substitution of Cord Blood for Infant Blood in the Neonatal Sepsis Evaluation
Anne Hansen^a, Peter Forbes^b, Rosanne Buck^c

^aDivision of Newborn Medicine, Children's Hospital and Harvard Medical School,
^bClinical Research Program, Children's Hospital, and
^cDepartment of Neonatology, Beth Israel Deaconess Medical Center, Boston, Mass., USA

Address of Corresponding Author

Biol Neonate 2005;88:12-18 (DOI: 10.1159/000083946)

Key Words

Umbilical cord blood
White blood cell band count
Blood culture
Neonatal sepsis

Abstract

Background: Evaluation of sepsis accounts for one third of all nursery triage admissions. If umbilical cord blood could be accurately substituted for infant blood, it would spare infants the discomfort of an invasive procedure and save both time and resources. While awaiting 48-hour blood culture results, we decide on clinical management based on whether the white blood cell (WBC) immature to total (I:T) granulocyte ratio is 0.2. Objectives: Our goal was to assess the correlation of complete blood count (CBC), I:T ratio and blood culture results between umbilical cord and infant blood. Methods: We conducted a prospective cohort study comparing CBC/differential and blood culture results of paired samples of umbilical cord and infant blood from term newborns. Results: We sent 113 paired samples of cord and infant venous blood for CBC/differential and blood culture. All 113 umbilical cord and infant blood cultures were negative, yielding a false-positive blood culture rate of zero. For 92% of babies, both the cord and infant blood I:T ratio were <0.2 or both were 0.2. Cord and infant WBC, hematocrit and platelet counts were moderately to highly correlated. Conclusion: We conclude that cord blood can be safely substituted for infant blood in routine sepsis evaluations of asymptomatic, term infants based on both the low false-positive cord blood culture rate and the significant association between high I:T ratios in cord and infant blood.

Author Contacts

Anne Hansen, MD, MPH
Division of Newborn Medicine, Children's Hospital
300 Longwood Avenue, Hunnewell 430
Boston, MA 02115 (USA)
Tel. +1 617 355 6027, Fax +1 617 730 0486, E-Mail anne.hansen@childrens.harvard.edu

Article Information

Received: August 23, 2004
Accepted after revision: November 23, 2004
Published online: February 10, 2005
Number of Print Pages : 7
Number of Figures : 1, Number of Tables : 3, Number of References : 20

Medline Abstract (ID 15711036)

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