Evidence map›Paper›PMID 34389321›Full record

ArticleThe Journal of pediatrics2021

Neonatal Reference Intervals for the Complete Blood Count Parameters MicroR and HYPO-He: Sensitivity Beyond the Red Cell Indices for Identifying Microcytic and Hypochromic Disorders.

Timothy M Bahr, Thomas R Christensen, Erick Henry, Jacob Wilkes, Robin K Ohls, Sterling T Bennett, Diane M Ward, Theodore J Pysher, Robert D Christensen

Open access · greenAbstract read
In one paragraph

Article in The Journal of pediatrics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Article
  2. Using the refineR algorithm to generate indirect reference intervals for newborn infants for the parameters "Micro-R" and "HYPO-He".Journal of perinatology : official journal of the California Perinatal Association · 2025
    Article
  3. Article
  4. Serum ferritin values in neonates <29 weeks' gestation are highly variable and do not correlate with reticulocyte hemoglobin content.Journal of perinatology : official journal of the California Perinatal Association · 2023
    Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Timothy M BahrDivision of Neonatology, University of Utah Health, Salt Lake City, UT; Center for Iron and Heme Disorders, University of Utah Health, Salt Lake City, UT. Electronic address: tim.bahr@hsc.utah.edu.
Thomas R ChristensenStudent, University of Utah, Salt Lake City, UT.
Erick HenryWomen and Newborns Clinical Program, Intermountain Healthcare, Salt Lake City, UT.
Jacob WilkesWomen and Newborns Clinical Program, Intermountain Healthcare, Salt Lake City, UT.
Robin K OhlsDivision of Neonatology, University of Utah Health, Salt Lake City, UT.
Sterling T BennettDepartment of Pathology, Intermountain Medical Center, Murray, UT.
Diane M WardDepartment of Pathology, University of Utah Health, Salt Lake City, UT.
Theodore J PysherDepartment of Pathology, University of Utah Health, Salt Lake City, UT; Pediatric Pathology, Primary Children's Hospital, Salt Lake City, UT.
Robert D ChristensenDivision of Neonatology, University of Utah Health, Salt Lake City, UT; Division of Hematology/Oncology, Department of Pediatrics, University of Utah Health, Salt Lake City, UT; Center for Iron and Heme Disorders, University of Utah Health, Salt Lake City, UT; Women and Newborns Clinical Program, Intermountain Healthcare, Salt Lake City, UT.
University of Utah · USIntermountain Healthcare · USIntermountain Medical Center · USPrimary Children's Hospital · US

Funding

Proteomics CoreU54DK110858 · NIDDK · UTAH STATE HIGHER EDUCATION SYSTEM--UNIVERSITY OF UTAH · PI Anna E Beaudin, JAMES Eric COX · 2016 to 2026
$8.6M
NIDDK NIH HHS U54 DK110858
6 · The paper itself

Abstract

objectiveTo create neonatal reference intervals for the MicroR and HYPO-He complete blood count (CBC) parameters and to test whether these parameters are sensitive early markers of disease at early stages of microcytic/hypochromic disorders while the CBC indices are still normal. STUDY

designWe retrospectively collected the CBC parameters MicroR and HYPO-He, along with the standard CBC parameters, from infants aged 0-90 days at Intermountain Healthcare hospitals using Sysmex hematology analyzers. We created reference intervals for these parameters by excluding values from neonates with proven microcytic disorders (ie, iron deficiency or alpha thalassemia) from the dataset.

resultFrom >11 000 CBCs analyzed, we created reference intervals for MicroR and HYPO-He in neonates aged 0-90 days. The upper intervals are considerably higher in neonates than in adults, validating increased anisocytosis and polychromasia among neonates. Overall, 52% of neonates with iron deficiency (defined by reticulocyte hemoglobin equivalent <25 pg) had a MicroR >90% upper interval (relative risk, 4.14; 95% CI, 3.80-4.53; P < .001), and 68% had an HYPO-He >90% upper interval (relative risk, 6.64; 95% CI, 6.03-7.32; P < .001). These 2 new parameters were more sensitive than the red blood cell (RBC) indices (P < .001) in identifying 24 neonates with iron deficiency at birth.

conclusionsWe created neonatal reference intervals for MicroR and HYPO-He. Although Sysmex currently designates these as research use only in the US, they can be measured as part of a neonate's CBC with no additional phlebotomy volume or run time and can identify microcytic and hypochromic disorders even when the RBC indices are normal.

Indexed as

Anemia, Iron-DeficiencyBiomarkersHumansInfantInfant, NewbornReference ValuesReticulocyte CountReticulocytesRetrospective StudiesBiomarkershypochromiairon deficiencyMCHMCVmicrocytosisreference intervals

Identifiers

PMID34389321
PMCPMC9123644
OpenAlexW3191673013

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.