PMID- 32702426
OWN - NLM
STAT- MEDLINE
DCOM- 20210120
LR  - 20210120
IS  - 1097-6833 (Electronic)
IS  - 0022-3476 (Linking)
VI  - 227
DP  - 2020 Dec
TI  - Prevalence and Utility of Low Mean Corpuscular Volume in Infants Admitted to the 
      Neonatal Intensive Care Unit.
PG  - 108-113.e2
LID - S0022-3476(20)30955-0 [pii]
LID - 10.1016/j.jpeds.2020.07.056 [doi]
AB  - OBJECTIVE: To determine the prevalence of low mean corpuscular volume (MCV) in 
      newborn infants admitted to the neonatal intensive care unit and to assess low 
      MCV as a diagnostic test for alpha thalassemia. STUDY DESIGN: Retrospective 
      analysis of all infants admitted to the neonatal intensive care unit between 
      January 2010 and October 2018 for which a complete blood count was performed 
      during the first 3 postnatal days. Infants with a low MCV were compared with 
      those with a normal MCV. Infants with positive hemoglobin Bart (Hb Bart) were 
      compared with those withnegative Hb Bart. Low MCV was also evaluated as a 
      diagnostic test for alpha thalassemia. RESULTS: A total of 3851 infants (1386 
      preterm, 2465 term) met the inclusion criteria and 853 (22.2%) had a low MCV. A 
      low MCV was more common in term (25%) compared with preterm infants (17.1%, 
      P < .001). Hb Bart positive newborn screening was identified in 133 infants 
      (3.5%). Hb Bart was positive in 11.1% of infants with low MCV compared with 1.3% 
      with normal MCV (P < .001). The sensitivity, specificity, positive predictive 
      value, and negative predictive value of low MCV for the diagnosis of alpha 
      thalassemia were 71.4%, 79.6%, 11.3%, and 98.7%, respectively. CONCLUSIONS: As Hb 
      Bart positive newborn screens were seen in only 11.1% of infants with 
      microcytosis, further diagnostic investigation may be warranted in individual 
      infants. Further research to correlate microcytosis with iron status in infants 
      and mothers is needed as well as studies using DNA analysis for the evaluation of 
      alpha thalassemia variants.
CI  - Copyright (c) 2020 Elsevier Inc. All rights reserved.
FAU - Guo, Rose
AU  - Guo R
AD  - Department of Pediatrics, Division of Neonatology, Thomas Jefferson University 
      Hospital/Nemours, Philadelphia, PA.
FAU - Neumann, Dana
AU  - Neumann D
AD  - Department of Pediatrics, Division of Neonatology, Thomas Jefferson University 
      Hospital/Nemours, Philadelphia, PA.
FAU - Lafferty, Margaret
AU  - Lafferty M
AD  - Department of Pediatrics, Division of Neonatology, Thomas Jefferson University 
      Hospital/Nemours, Philadelphia, PA.
FAU - Boelig, Rupsa
AU  - Boelig R
AD  - Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Thomas 
      Jefferson University, Philadelphia, PA.
FAU - Bell-Carey, Brandi
AU  - Bell-Carey B
AD  - Department of Pediatrics, Division of Neonatology, Thomas Jefferson University 
      Hospital/Nemours, Philadelphia, PA.
FAU - Edwards, Caroline
AU  - Edwards C
AD  - Department of Pediatrics, Division of Neonatology, Thomas Jefferson University 
      Hospital/Nemours, Philadelphia, PA.
FAU - Greenspan, Jay S
AU  - Greenspan JS
AD  - Department of Pediatrics, Division of Neonatology, Thomas Jefferson University 
      Hospital/Nemours, Philadelphia, PA.
FAU - Derman, Richard
AU  - Derman R
AD  - Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Thomas 
      Jefferson University, Philadelphia, PA.
FAU - Aghai, Zubair H
AU  - Aghai ZH
AD  - Department of Pediatrics, Division of Neonatology, Thomas Jefferson University 
      Hospital/Nemours, Philadelphia, PA. Electronic address: zaghai@nemours.org.
LA  - eng
PT  - Journal Article
PT  - Validation Study
DEP - 20200721
PL  - United States
TA  - J Pediatr
JT  - The Journal of pediatrics
JID - 0375410
RN  - 0 (Hemoglobins, Abnormal)
SB  - IM
MH  - Case-Control Studies
MH  - *Erythrocyte Indices
MH  - Female
MH  - Hemoglobins, Abnormal/*analysis
MH  - Humans
MH  - Infant, Newborn
MH  - Intensive Care Units, Neonatal
MH  - Male
MH  - Neonatal Screening/methods
MH  - Predictive Value of Tests
MH  - Pregnancy
MH  - Retrospective Studies
MH  - alpha-Thalassemia/*blood/diagnosis
OTO - NOTNLM
OT  - alpha thalassemia
OT  - hemoglobin Bart
OT  - infant
OT  - iron deficiency
OT  - microcytosis
EDAT- 2020/07/24 06:00
MHDA- 2021/01/21 06:00
CRDT- 2020/07/24 06:00
PHST- 2020/05/06 00:00 [received]
PHST- 2020/07/16 00:00 [revised]
PHST- 2020/07/17 00:00 [accepted]
PHST- 2020/07/24 06:00 [pubmed]
PHST- 2021/01/21 06:00 [medline]
PHST- 2020/07/24 06:00 [entrez]
AID - S0022-3476(20)30955-0 [pii]
AID - 10.1016/j.jpeds.2020.07.056 [doi]
PST - ppublish
SO  - J Pediatr. 2020 Dec;227:108-113.e2. doi: 10.1016/j.jpeds.2020.07.056. Epub 2020 
      Jul 21.