Reference values of leukocyte and lymphocytes populations in umbilical cord and capillary blood in healthy Mexican newborns

Main Article Content

S. Scheffer-Mendoza
S.E. Espinosa-Padilla
G. López-Herrera
F. Mujica-Guzmán
M.G. López-Padilla
L. Berrón-Ruiz


Capillary blood, Umbilical cord blood, Leukocytes, Newborn, Reference value, Lymphocyte populations


Introduction: In newborns, dramatic changes occur in the blood and bone marrow during the first hours; there are rapid fluctuations in the quantities of leukocytes populations. In this work, we investigated leukocytes subsets counts in two types of blood samples (cord blood and capillary blood) extracted from healthy newborns.

Methods: Blood samples from Mexican neonates were collected by Instituto Nacional de Pediatría with written informed consent. For all samples we determined leukocytes populations; neutrophils, monocytes, total lymphocytes, and populations: T CD3+ cells, TCD4+ cells, T CD8+ cells, B CD19+ cells and NK CD16+56 cells by flow cytometry. We used the Mann-Whitney U test to compare leukocytes of cord and capillary blood; also to analyze the differences between gender and we obtained reference values of the cord and capillary blood in neonates.

Results: We observed higher absolute counts and frequencies of total lymphocyte in capillary blood compared with cord blood. In absolute numbers, the capillary blood showed significant differences in neutrophils, monocytes, lymphocytes, T CD3+ cells, T CD4+ cells, T CD8+ cells, B CD19+ cells, and NK cells; no significant differences were observed between genders.

Discussion: Our data contribute to newborn Mexican reference values for all these populations of leukocytes. We found that the dispersal range differs between the two types of blood, suggesting a different fate in the immune response. Immunophenotyping of the blood cell population to identify these cells is an essential tool in the diagnosis and follow-up of neonates with immunodeficiencies and other immune disorders.

Abstract 19 | PDF Downloads 24


1. de Vries E, de Groot R, de Bruin-Versteeg S, Comans-Bitter WM, van Dongen JJ. Analysing the developing lymphocyte system of neonates and infants. Eur J Pediatr. 1999;158(8):611-7.

2. Pranke P, Failace RR, Allebrandt WF, Steibel G, Schmidt F, Nardi NB. Hematologic and immunophenotypic characterization of human umbilical cord blood. Acta Haematol. 2001;105(2):71-6.

3. Hollis VS, Holloway JA, Harris S, Spencer D, van Berkel C, Morgan H. Comparison of venous and capillary differential leukocyte counts using a standard hematology analyzer and a novel microfluidic impedance cytometer. PLoS One. 2012;7(9):e43702.

4. Tangye SG, Deenick EK, Palendira U, Ma CS. T cell-B cell interactions in primary immunodeficiencies. Ann N Y Acad Sci. 2012;1250:1-13.

5. Aguirre-Gamboa R, Joosten I, Urbano PCM, van der Molen RG, van Rijssen E, van Cranenbroek B, et al. Differential effects of environmental and genetic factors on T and B cell immune traits. Cell Rep. 2016;17(9):2474-87.

6. D’Arena G, Musto P, Cascavilla N, Di Giorgio G, Fusilli S, Zendoli F, et al. Flow cytometric characterization of human umbilical cord blood lymphocytes: immunophenotypic features. Haematologica. 1998;83(3):197-203.

7. Mishra A, Gupta M, Dalvi A, Ghosh K, Madkaikar M. Rapid flow cytometric prenatal diagnosis of primary immunodeficiency (PID) disorders. J Clin Immunol. 2014;34(3):316-22.

8. Basha S, Surendran N, Pichichero M. Immune responses in neonates. Expert Rev Clin Immunol. 2014;10(9):1171-84.

9. Proytcheva MA. Issues in neonatal cellular analysis. Am J Clin Pathol. 2009;131(4):560-73.

10. Zhou G, Chen J, Lee S, Clark T, Rowley JD, Wang SM. The pattern of gene expression in human CD34(+) stem/progenitor cells. Proc Natl Acad Sci U S A. 2001;98(24):13966-71.

11. Hordyjewska A, Popiolek L, Horecka A. Characteristics of hematopoietic stem cells of umbilical cord blood. Cytotechnology. 2015;67(3):387-96.

12. Quinello C, Silveira-Lessa AL, Ceccon ME, Cianciarullo MA, Carneiro-Sampaio M, Palmeira P. Phenotypic differences in leucocyte populations among healthy preterm and full-term newborns. Scand J Immunol. 2014;80(1):57-70.

13. Al-Deghaither SY. Impact of maternal and neonatal factors on parameters of hematopoietic potential in umbilical cord blood. Saudi Med J. 2015;36(6):704-12.

14. Newman TB, Puopolo KM, Wi S, Draper D, Escobar GJ. Interpreting complete blood counts soon after birth in newborns at risk for sepsis. Pediatrics. 2010;126(5):903-9.

15. Christensen RD, Calhoun DA, Rimsza LM. A practical approach to evaluating and treating neutropenia in the neonatal intensive care unit. Clin Perinatol. 2000;27(3):577-601.

16. Warny M, Helby J, Nordestgaard BG, Birgens H, Bojesen SE. Lymphopenia and risk of infection and infection-related death in 98,344 individuals from a prospective Danish population-based study. PLoS Med. 2018;15(11):e1002685.

17. Riley LK, Rupert J. Evaluation of Patients with Leukocytosis. Am Fam Phys. 2015;92(11):1004-11.

18. Karenberg K, Hudalla H, Frommhold D. Leukocyte recruitment in preterm and term infants. Mol Cell Pediatr. 2016;3(1): 35.

19. Bousfiha AA, Jeddane L, Ailal F, Al Herz W, Conley ME, Cunningham-Rundles C, et al. A phenotypic approach for IUIS PID classification and diagnosis: guidelines for clinicians at the bedside. J Clin Immunol. 2013;33(6):1078-87.

20. Kanegane H, Hoshino A, Okano T, Yasumi T, Wada T, Takada H, et al. Flow cytometry-based diagnosis of primary immunodeficiency diseases. Allergol Int. 2018;67(1):43-54.

21. Abraham RS, Aubert G. Flow cytometry, a versatile tool for diagnosis and monitoring of primary immunodeficiencies. Clin Vaccine Immunol CVI. 2016;23(4):254-71.

22. Bonilla FA, Khan DA, Ballas ZK, Chinen J, Frank MM, Hsu JT, et al. Practice parameter for the diagnosis and management of primary immunodeficiency. J Allergy Clin Immunol. 2015;136(5), 1186-205 e1-78.

23. Guilmot A, Hermann E, Braud VM, Carlier Y, Truyens C. Natural killer cell responses to infections in early life. J Innate Immunity. 2011;3(3):280-8.

24. Hsu AP, McReynolds LJ, Holland SM. GATA2 deficiency. Curr Opin Allergy Clin Immunol. 2015;15(1):104-9.

25. Juretic E, Uzarevic B, Petrovecki M, Juretic A. Two-color flow cytometric analysis of preterm and term newborn lymphocytes. Immunobiology. 2000;202(5):421-8.

26. Prabhu SB, Rathore DK, Nair D, Chaudhary A, Raza S, Kanodia P, et al. Comparison of human neonatal and adult blood leukocyte subset composition phenotypes. PLoS One. 2016;11(9):e0162242.

27. Chang YH, Yang SH, Wang TF, Lin TY, Yang KL, Chen SH. Complete blood count reference values of cord blood in Taiwan and the influence of gender and delivery route on them. Pediatr Neonatol. 2011;52(3):155-60.