Adjekuko, Collins Ohwonigho

Asuquo, Etim Emmanuel

Emokpae, Mathias Abiodun

Jeremiah, Zaccheaus Awortu

Osadolor, Humphrey Benedo

English

AJOL - African Journals Online

SJMLS - 6 (2) - 002Variation in some Haematological Parameters in Newborns at Different Locations in Delta State, Nigeria.*,1 2 3Collins Ohwonigho Adjekuko , Etim Emmanuel Asuquo , Mathias Abiodun Emokpae , Humphrey Benedo 3 4Osadolor  and Zaccheaus Awortu Jeremiah1Department of Medical Laboratory Services, General Hospital, Okwe-Asaba, Nigeria , Department of 2Haematology, Federal Medical Centre Yola, Adamawa State, Nigeria , Department of Medical Laboratory Science, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin City, 3Nigeria , Haematology and Blood Transfusion Science Unit, Department of Medical Laboratory Sciences, 4College of Health Sciences, Niger Delta University, Wilberforce Island, Bayelsa State, Nigeria Author for Correspondence*: adjekukocollins27@gmail.com/+2348037111026.Sokoto Journal of Medical Laboratory Science 2021; 6(2): 11 - 15SJMLSAbstract:Haematological parameters in the newborn are Introduction:commonly used tool to assess the health or Haematological profile in neonates is useful in disease status of the newborn. These parameters, evaluating the state of health or disease of the to a large extent are believed to vary with newborn.  In the medical  laboratory,  geographical locations. The aim of this study was determination of full blood count is a routine to establish the effect of geographical location on haematology investigation for the identification some haematological parameters in the of anaemia, sepsis, thrombocytopenia or any newborns at birth. Blood samples were collected haematological disease that may manifest during at birth from 374 apparently healthy newborns, the neonatal period (Younis et al., 2017).  and their full blood counts was determined using Following difficulties often encountered in Sysmex KX-21N haematology analyzer. The collecting adequate blood specimen for full mean ± standard deviation of red blood cell (4.81 blood count, the use of cord blood has become a ± 3.69), white blood cell (14.08 ± 6.17), veritable alternative (Lee et al., 2010). The cord Neutrophil counts (8.31 ± 4.31) and mean blood also has additional advantage of revealing platelet volume (10.34 ± 1.25) among newborns the foetal haematopoiesis as it is enriched with delivered in Warri were significantly higher haematopoietic stem cells and progenitors when compared with newborns delivered in (Younis et al., 2017; Chang et al., 2011).Asaba with red blood cell (4.27 ± 0.57), white blood cell (12.61 ± 3.86), Neutrophil counts Haematological values in neonatal period are (6.54 ± 2.55) and mean platelet volume (9.72 ± however, readily affected by varying factors 0.97). This study revealed significant differences such as gender, race, time of blood sample in mean red blood cell counts (p = 0.0470), white collection, gestational age, birth weight, mode of blood cell counts (p = 0.0062), neutrophil counts delivery, geographical location amongst others (p < 0.0001) and mean platelet volume (p < (El-Gendy et al., 2016; Proytcheva, 2009).  For 0.0001) among newborns in the two study example, a significant difference was observed locations. Therefore, the use of uniform in the neutrophil count of neonates from vaginal reference range in the clinical management of deliveries (p = 0.0246), when compared with neonates from these locations should be caesarean deliveries (Adjekuko et al., 2018). revisited. The understanding of these observed Other studies have also revealed that premature changes in the birthplace of newborns could neonates have a lower red blood cell count with a assist paediatricians and neonatologists in the shorter cell lifespan, low haemoglobin and diagnosis and clinical management of newborns haematocrit levels, as well as higher mean cell in various localities. volume, when compared with term neonates (Proytcheva, 2009).Keywords:  Newborns, haematological parameters, geographical location. SJMLS Volume 6, Number , 2021    Page 112 JuneOccupational exposure to pollutions from oil and deliveries. The birth weights ranged from 1.9kg gas explorations, petroleum products and fumes – 4.7kg with a mean birth weight of 3.1 ± 0.5 kg.  have been reported to have toxic effects on various organs and body systems with high Exclusion criteria:impact on the haematopoietic system (Christian All stillbirths and/or newborns delivered before et al., 2016 Adienbo et al., 2010). Environmental admission into the labour ward were excluded pollutants have also been reported to cross the from the study.placental barrier (Tilley and Fry, 2015) and possibly affect the haematopoietic system of the Inclusion Criteria: Healthy newborns with no newborns. Studies have shown that Warri systemic illness as certified by the Consultant metropolis was more prone to environmental Paediatrician were included in this study.pollutants from toxic metals when compared with Asaba location (Edosomwan et al., 2016; Ethical approval:Osakwe et al., 2012; Etchie et al., 2011). A The study was approved by the ethical un i formed re fe rence  range  i s  o f ten  committees of both health institutions thind iscr imina te ly  used  by  hea l thcare  (FMC/ASB/28, 20  April, 2016; CHW/ECC thprofessionals in the clinical management of VOL1/095, 4  August, 2016), while written neonates in Delta State. It has become imperative informed consent was obtained from the mothers based on finding from this study to check if there of every newborn prior to delivery and before exist any differences in the haematological specimen collection.  indices of neonates at different birthplace in order to assist in the diagnosis and management Sample collection and processingof newborns in various locations in Nigeria. It is Three milliliters (3mL) of cord blood were collected believed that the knowledge of these changes by well experienced midwives trained in cord blood could assist paediatricians and neonatologists in collection from the umbilical cord of all neonates the evaluation, diagnosis and management of immediately after delivery, and dispensed into newborns in these localities. Therefore, this blood bottles containing di-potassium salt of study aims to evaluate variations in ethylene di-amine tetra-acetic acid (K EDTA). Full 2 haematological indices in cord blood of blood count was determined within 3 hours of newborns at Warri, a crude oil exploration city sample collection according to manufacturer's and Asaba the state capital of Delta State. instruction using Haematology auto-analyser model of Sysmex KX-21N, manufactured by Materials and methods Sysmex Corporation, Kobe, Japan. Haematological Study population parameters analyzed were, red blood cell (RBC) This is a hospital based cross-sectional study count, mean cell volume (MCV), packed cell carried out at Federal Medical Centre, Asaba and volume (PCV), white blood cell (WBC) count, Central hospital, Warri respectively in Delta neutrophil count, lymphocyte count, platelet count, State, Nigeria between April and November mean platelet volume (MPV). On the other hand, 2016. A total of 374 apparently healthy newborns Neutrophil-Lymphocyte Ratio (NLR) was with no systemic illness as certified by the manually calculated as absolute neutrophil count Consultant Paediatrician were included in this divided by absolute lymphocyte count, and Platelet-study. Out of the 374 newborns, 190 were Lymphocyte Ratio (PLR) was calculated as Platelet delivered in Warri consisting of 70 females and count divided by absolute lymphocyte count.120 males; 44 delivery was through caesarean section, while 146 was through normal vaginal Statistical analysis delivery. Their birth weight ranged from 1.4kg – Haematological profile of the study population 4.2kg with a mean birth weight of 3.2 ± 0.5 kg. was expressed as the mean ± standard deviation On the other hand, 184 newborns were delivered (mean ± SD) and Student's t-test was used to in Asaba comprising of 86 females and 98 males; compare the means using the statistical software 24 newborns were delivered through caesarean INSTAT® (Graph Pad Inc., La Lolla, CA, USA). section while 160 were normal vaginal The level of significance was set at p < 0.05.SJMLSSJMLS Volume 6, Number , 2021    Page 122 JuneResults: ± 3.69), white blood cell count (14.08 ± 6.17), Out of the 374 newborns enrolled in this cross- Neutrophil counts (8.31 ± 4.31) and significantly sectional study, 190 (50.8%) newborns were higher (p < 0.001) mean platelet volume  (10.34 ± delivered in Central hospital, Warri while 184 1.25) among the newborns delivered in Warri (49.2%) were delivered at the Federal Medical centre when compared with newborns delivered at C e n t r e ,  A s a b a .  O t h e r  d e m o g r a p h i c  the Asaba centre with mean red blood cell count characteristics of the newborns according to (4.27 ± 0.57), white blood cell count (12.61 ± location of study are listed in Table 1. 3.86), Neutrophil counts (6.54 ± 2.55) and mean platelet volume (9.72 ± 0.97) respectively. Table 2 shows the comparison of some However packed cell volume, lymphocytes and haematological parameters among neonates at platelet counts, mean cell volume, neutrophil-to-birth in Warri and Asaba. There was a significantly lymphocyte ratio and platelet-to-lymphocyte ratio higher (p < 0.05)  mean red blood cell count (4.81 revealed no significant difference (p > 0.05). SJMLSSJMLS Volume 6, Number , 2021    Page 132 JuneTable 1.0: Some sociodemographic data of newborns according to location of study Sociodemographic Parameter Warri (n=190)  Asaba (n= 184)  Gender   Male 120 (63.2%)  98  (53.4%)  Female 70 (36.8%) 86  (46.6%)     Mode of Delivery:   Caesarean section       44 (23.3%) 24  (12.8%)  Normal vaginal delivery    146 (76.7%)  160  (87.2%)     Birth Weight:   Birth weight (mean ± SD) (kg)      3.2 ± 0.5 3.1 ± 0.5  Range 1.4 - 4.2 1.9 -  4.7  Table 2: Comparison of some haematological parameters among neonates at birth in Warri and Asaba.Parameters Warri (n=190) Asaba (n=184) P-value  RBC (1012/L) 4.81±3.69 4.27±0.57 0.0470* PCV (%)  42.10±11.71 41.46±5.10 0.4970 WBC (109/L) 14.08±6.17 12.61±3.86 0.0062* Neut (109/L) 8.31±4.31 6.54±2.55 <0.0001* Lymph (109/L) 4.64±2.50 4.62±1.90 0.9308 Platelet (109/L) 240.29±98.39 249.40±67.15 0.2978 MCV (fL) 93.92±9.12 96.24±14.22 0.0603 NLR 3.50±16.02 1.60±0.84 0.1105 PLR 66.70±42.20 64.08±31.29 0.5209 MPV (fL) 10.34±1.25 9.72±0.97 <0.0001*  * Significant.Key: RBC=Red Blood Cell counts; PCV= Packed Cell Volume; WBC=White Blood Cell counts; Neut=Neutrophil counts; Lymph= Lymphocyte counts; MCV=Mean Cell Volume; NLR= Neutrophil/Lymphocyte Ratio; PLR= Platelet/Lymphocyte Ratio; MPV= Mean Platelet VolumeSJMLSSJMLS Volume 6, Number , 2021    Page 142 JuneDiscussion: There was a significant increase in neutrophil Haematological parameters in the newborn are count (p < 0.0001) among newborns delivered in commonly used to assess the health or disease Warri when compared with those delivered in status of the newborn and to a large extent, the Asaba. Again, this is in agreement with the values of these haematological parameters are reports by Christian et al. (2016) who reported a believed to be influenced by geographical significant increase in WBC and neutrophil locations. counts among test subjects exposed to petroleum pollution when compared with control subjects. From this study, some haematological The mean platelet count of newborns delivered parameters of the newborns were compared in Warri was lower when compared with based on the location of their deliveries. newborns in Asaba, however, this difference was Interesting changes in some haematological not statistically significant (p = 0.2978). This parameters were observed in the cord blood of finding is also in agreement with report by the newborns delivered at different study Christian et al. (2010).  However, the mean locations. Specifically, we observed that the red platelet volume (MPV) of newborns delivered in blood cell (RBC) counts of the newborns Warri was significantly higher (p < 0.0001), delivered at the Central Hospital Warri were when compared with newborns in Asaba. An significantly higher (p < 0.05) when compared increase in mean platelet volume (MPV) may with newborns delivered at the Federal Medical indicate the release of large platelets into Centre, Asaba (Table 2). This result is however in circulation following platelet destruction or contrast with earlier reports by Adienbo and utilization (Kotwal, 2014).  The reason for the Nwafor (2010), who reported a significant significant increase in MPV among newborns in decrease in mean red blood cell (RBC) count, Warri remains unclear but may be attributed to packed cell volume (PCV) and haemoglobin the release of immature large platelets in (Hb) levels from a similar study in the Niger response to the low platelet counts recorded Delta region. The reason for this difference is not among these newborns.clear, although this study was based on newborns cord blood specimen while the study by Adienbo Conclusion:and Nwafor (2010) reported on adult venous There are significant differences in the white blood samples. blood cell counts, red blood cell counts, neutrophil counts and mean platelet volume The white blood cell (WBC) counts from this among newborns in the two study locations in study was significantly higher (p = 0.0062) Delta state, south-south Nigeria. The use of among newborns from Warri when compared uniform reference range in the clinical with newborns from Asaba. This result is in management of neonates from these locations agreement with previous reports (Egwurugwu et should therefore be reconsidered, as an al., 2013; Adienbo and Nwafor, 2010). They understanding of these observed changes in the opined that the increased white blood cell count newborns could assist paediatricians and may be due to response of the myeloid and neonatologists in the diagnosis and clinical megakaryocytic stem cells to a continued management of newborns in these localities.exposure to gas flares.  Some studies have shown that stem cells may have the selective advantage Disclaimer: The views expressed in this article of proliferation and resistance to toxicity of oil are that of the authors and not an official position and its metabolites. Although this present study of any hospital or institution.did not evaluate the level of environmental pollution between the two geographical Financial Sponsorship: The study was not locations, the differences observed in the white sponsored, the equipment used was provided by blood cell count may not be unconnected with the hospitals in which this work was done. the environmental pollutions associated with gas flaring and oil exploration. Acknowledgement: The authors are sincerely grateful to the management of Federal Medical SJMLSSJMLS Volume 6, Number , 2021    Page 152 JuneCenter Asaba and Central Hospital, Warri for Applied Science Research; 5 (1):98-104.providing the environment and equipment for El-Gendy, F.M., Allam, A.A., Allam M.M., et al., this research work. (2016). Hematological parameters of the newborns delivered vaginally versus Conflict of Interest: caesarean section. Menoufla Medical There is no conflict of interest regarding this Journal; 29: 259-264.work among the authors. Etchie, T.O., Etchie, A.T. and Adewuyi, G.O. (2011). Source identification of chemical References: contaminants in environmental media of a Adienbo, O.M. and Nwafor, A. (2010). Effect of rural settlement. Research Journal of prolonged exposure to gas flaring on some Environmental Sciences; 5: 730-740.hematological parameters of humans in the Kotwal, J. (2011). Approach to neonatal Niger Delta region of Nigeria. Journal of thrombocytopenia: immature platelet Applied Science and Environmental fraction has a major role. Medical Journal of Management; 14(1):13-15. Armed Forces India; 67: 212-214. Adjekuko, C.O., Emokpae, M.A., Osadolor, Lee, J.C., Ahern, T.P., Chaves, F.P., et al., (2010). H.B., et al. (2018). Prevalence of Utility of hematologic and volume, thrombocytopenia among apparently conductivity, and scatter parameters from healthy newborns in Delta state, Nigeria. umbilical cord blood in predicting New Zealand Journal of Medical Laboratory chorioamnionitis. International Journal of Science; 72(2): 54-56. Laboratory Hematology; 32: 351-359.Chang, Y. H., Yang, S.H., Wang, T.F., et al. (2011). Osakwe, S.A., Akpoveta, O.V.  Okoh, B.E., et Complete blood count reference values of al., (2012). Chemical forms of heavy metals cord blood in Taiwan and the influence of in soils around municipal waste dumpsites in gender and delivery route on them. Asaba metropolis, Delta State. Chemical Paediatrics Neonatology; 52: 155– 160. Speciation and Bioavailability; 24: 23-30.Christian, S.G., Elekima, I., Obisike, U.A., et al. Proytcheva, M.A. (2009). Issues in neonatal ( 2 0 1 6 ) .  E f f e c t  o f  p e t r o l e u m  o n  cellular analysis. American Journal of hematological parameters and Lead level in Clinical Pathology; 131: 560–573.fuel attendants in Port Harcourt, Nigerian. Tilley, S.K. and Fry, R.C. (2015). Priority International Journal of Science and environmental contaminants: Understanding Research; 5 (3): 280-283. their sources and exposure, biological Edosomwan, E.U., Ainerua, M. and Izevbizua, mechanism and impact on health. In Systems D.O. (2016). Heavy metal levels in dried fish Biology in Toxicology and Environmental consumed in Benin and Warri metropolis; Health. Elsevier Inc. 117-169. doi: Levels and Health risk assessment. African 10.1016/b978-0-12-801564-3.00006-7Scientist; 17: 93-96. Younis, M.S., Mahmoud, M.E. and Babiker, Egwurugwu, J.N., Nwafor, N. and Ezekwe, S. A.M. (2017). Effect of delivery mode on (2013). Impacts of prolonged exposure to gas newborns cord blood hematological flares on some blood indices in humans in the p a r a m e t e r s .  C u k u r o v a  M e d i c a l  Niger Delta Region, Nigeria. Archives of Journal;42(4):735–740. Citation: Collins Ohwonigho Adjekuko, Etim Emmanuel Asuquo, Mathias Abiodun Emokpae, Humphrey Benedo Osadolor and Zaccheaus Awortu Jeremiah. Variation in some Haematological Parameters in Newborns at Different Locations in Delta State, Nigeria. Sokoto Journal of Medical Laboratory Science;6(2): 11 - 15.Copyright. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Variation in some Haematological Parameters in Newborns at Different Locations in Delta State, Nigeria

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Variation in some Haematological Parameters in Newborns at Different Locations in Delta State, Nigeria

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