Towards improved neonatal care: Developing reference intervals for biochemical parameters in umbilical cord blood: An Indian study

doi:10.5409/wjcp.v14.i4.107181

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World Journal of Clinical Pediatrics

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2219-2808

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Pediatr. Dec 9, 2025; 14(4): 107181
Published online Dec 9, 2025. doi: 10.5409/wjcp.v14.i4.107181

Towards improved neonatal care: Developing reference intervals for biochemical parameters in umbilical cord blood: An Indian study

Keyur Sabnis, Swati Ghanghurde, Akash Shukla, Dhriti Sukheja, Mohit Vijay Rojekar

Keyur Sabnis, Akash Shukla, Dhriti Sukheja, III YR MBBS Student, Rajiv Gandhi Medical College, Thane 400605, Maharashtra, India

Swati Ghanghurde, Department of Pathology, Rajiv Gandhi Medical College, Thane 400605, Maharashtra, India

Mohit Vijay Rojekar, Department of Biochemistry, Rajiv Gandhi Medical College, Thane 400605, Maharashtra, India

Co-corresponding authors: Swati Ghanghurde and Mohit Vijay Rojekar.

Author contributions: Sabnis K, Shukla A, Rojekar MV identified the problem, designed the study, interpreted data and drafted the manuscript; Sukheja D screened and selected the pregnant mothers; Ghanghurde S and Rojekar MV, performed the laboratory analysis; All authors critically reviewed the draft and approved the final manuscript.

Institutional review board statement: The study protocol was reviewed and ethically approved by the Institutional Review Board (IRB) and Institution Clinical Ethics Committees (ICEC) of Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, India.

Informed consent statement: The process of delivery being an exhaustive event, the attending midwives obtained a written informed consent in accordance with the Helsinki Declaration and assisted all the participating mothers to answer the questionnaire before entering the labor room.

Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.

STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.

Data sharing statement: The datasets generated and/or analysed during the current study are not publicly available since they are owned by the institute of Rajiv Gandhi Medical College. They can be made available from the corresponding author on reasonable request.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Mohit Vijay Rojekar, Professor, Department of Biochemistry, Rajiv Gandhi Medical College, Kalwa, Thane 400605, Maharashtra, India. drmohi44@gmail.com

Received: March 18, 2025
Revised: April 21, 2025
Accepted: June 10, 2025
Published online: December 9, 2025
Processing time: 227 Days and 9.7 Hours

Abstract

BACKGROUND

The reference ranges for biochemical parameters can fluctuate due to factors like altitude, age, gender, and socioeconomic conditions. These values are crucial for interpreting laboratory data and guide clinical treatment decisions. Currently, there is no established set of reference intervals for cord blood biochemical parameters of newborns in India, particularly in Mumbai.

AIM

To create cord blood biochemical parameters reference intervals specifically for Mumbai, India.

METHODS

A cross-sectional study was conducted in an Indian tertiary care hospital. This study focused on healthy newborns with normal birth weight, born to pregnant mothers without health issues. Cord blood samples, approximately 2-3 mL in volume, were collected from 210 term neonates. These samples were divided into fluoride (glucose) and clot activator (serum) tubes and were subsequently analyzed in the institute's biochemical laboratory. The data obtained from the analysis was then subjected to statistical analysis. The result of the Shapiro-Wilk test suggested non-normality in the data distribution. Consequently, non-parametric statistics were utilized for analysis. The Mann-Whitney U test was utilized to compare parameter distributions among different factors, including the infant’s sex, delivery method, maternal age, and obstetric history. A significance level of P < 0.05 was considered to indicate statistical significance.

RESULTS

The following represent the median figures and central 95 percentile reference intervals for biochemical parameters in umbilical cord blood of newborns: Serum direct bilirubin = (0.1–0.55) mg/dL, indirect bilirubin = (0.64–2.26) mg/dL, total bilirubin = (0.62–3.14) mg/dL, creatinine = (0.27–0.76) mg/dL, sodium = (128.19–143.26) mmol/L, chloride = (100.19–111.68) mmol/L, potassium = (1.62–9.98) mmol/L and plasma glucose = (24.75–94.23) mg/dL. Statistically significant differences were observed in serum sodium, potassium, and plasma glucose levels when comparing delivery modes.

CONCLUSION

This is the pioneering study in which first time, the biochemical reference intervals in cord blood for newborns are established in western India. The values are applicable for newborns from this area. Larger study throughout the country is required.

Keywords: Biochemical Parameters; Reference interval; Umbilical cord blood; Peripheral venous blood; Neonates; India

Core Tip: The reference ranges for biochemical parameters can fluctuate due to factors like altitude, age, gender, and socioeconomic conditions. These values are crucial for interpreting laboratory data and guide clinical treatment decisions. Currently, there is no established set of reference intervals for cord blood biochemical parameters of newborns. This study seeks to create these reference intervals.