{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T17:02:45Z","timestamp":1790960565682,"version":"4.1.0"},"reference-count":25,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>A complete blood count (CBC) with white blood cell differential is commonly ordered to evaluate newborns at risk for sepsis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>OBJECTIVES:<\/jats:title>\n                  <jats:p>To quantify how well components of the CBC predict sepsis in the first 72 hours after birth.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>For this retrospective cross-sectional study we identified 67 623 term and late-preterm (\u226534 weeks gestation) newborns from 12 northern California Kaiser hospitals and 1 Boston, Massachusetts hospital who had a CBC and blood culture within 1 hour of each other at &amp;lt;72 hours of age. We compared CBC results among newborns whose blood cultures were and were not positive and quantified discrimination by using receiver operating characteristic curves and likelihood ratios.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Blood cultures of 245 infants (3.6 of 1000 tested newborns) were positive. Mean white blood cell (WBC) counts and mean absolute neutrophil counts (ANCs) were lower, and mean proportions of immature neutrophils were higher in newborns with infection; platelet counts did not differ. Discrimination improved with age in the first few hours, especially for WBC counts and ANCs (eg, the area under the receiver operating characteristic curve for WBC counts was 0.52 at &amp;lt;1 hour and 0.87 at \u22654 hours). Both WBC counts and ANCs were most informative when very low (eg, the likelihood ratio for ANC &amp;lt; 1000 was 115 at \u22654 hours). No test was very sensitive; the lowest likelihood ratio (for WBC count \u2265 20 000 at \u22654 hours) was 0.16.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION:<\/jats:title>\n                  <jats:p>Optimal interpretation of the CBC requires using interval likelihood ratios for the newborn's age in hours.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2010-0935","type":"journal-article","created":{"date-parts":[[2010,10,26]],"date-time":"2010-10-26T03:59:49Z","timestamp":1288065589000},"page":"903-909","source":"Crossref","is-referenced-by-count":179,"title":["Interpreting Complete Blood Counts Soon After Birth in Newborns at Risk for Sepsis"],"prefix":"10.1542","volume":"126","author":[{"given":"Thomas B.","family":"Newman","sequence":"first","affiliation":[{"name":"Departments of Epidemiology and Biostatistics and Pediatrics, School of Medicine, University of California, San Francisco, California;"},{"name":"Division of Research, Kaiser Permanente Medical Care Program, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Puopolo","sequence":"additional","affiliation":[{"name":"Department of Newborn Medicine and Channing Laboratory, Brigham and Women's Hospital, Boston, Massachusetts;"},{"name":"Division of Newborn Medicine, Children's Hospital Boston, Boston, Massachusetts;"},{"name":"Harvard Medical School, Boston, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soora","family":"Wi","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Medical Care Program, Oakland, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Draper","sequence":"additional","affiliation":[{"name":"Department of Applied Mathematics and Statistics, University of California, Santa Cruz, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel J.","family":"Escobar","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Medical Care Program, Oakland, California;"},{"name":"Department of Pediatrics, Kaiser Permanente Medical Center, Walnut Creek, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2010,11,1]]},"reference":[{"issue":"RR-11","key":"2021121010113561900_B1","first-page":"1","article-title":"Prevention of perinatal group B streptococcal disease. Revised guidelines from CDC","volume":"51","author":"Schrag","year":"2002","journal-title":"MMWR Recomm Rep"},{"key":"2021121010113561900_B2","unstructured":"American Academy of Pediatrics. Practice guideline endorsement. Prevention of perinatal group B streptococcal disease: revised guidelines from CDC\u20082002. Available at: http:\/\/aappolicy.aappublications.org\/misc\/Prevention_of_Perinatal_Group_B.dtl. Accessed December 7, 2009"},{"issue":"4","key":"2021121010113561900_B3","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/S0022-3476(94)70018-4","article-title":"Peripheral leukocyte count and leukocyte indexes in healthy newborn term infants","volume":"125","author":"Schelonka","year":"1994","journal-title":"J Pediatr"},{"issue":"1","key":"2021121010113561900_B4","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S0022-3476(79)80096-7","article-title":"The neonatal blood count in health and disease. I. Reference values for neutrophilic cells","volume":"95","author":"Manroe","year":"1979","journal-title":"J Pediatr"},{"issue":"2 pt 1","key":"2021121010113561900_B5","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1542\/peds.106.2.256","article-title":"Neonatal sepsis workups in infants \u22652000 grams at birth: a population-based study","volume":"106","author":"Escobar","year":"2000","journal-title":"Pediatrics"},{"issue":"1","key":"2021121010113561900_B6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1053\/j.semperi.2008.10.010","article-title":"The CBC: reference ranges for neonates","volume":"33","author":"Christensen","year":"2009","journal-title":"Semin Perinatol"},{"issue":"5","key":"2021121010113561900_B7","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1542\/peds.113.5.1173","article-title":"Are complete blood cell counts useful in the evaluation of asymptomatic neonates exposed to suspected chorioamnionitis?","volume":"113","author":"Jackson","year":"2004","journal-title":"Pediatrics"},{"issue":"4","key":"2021121010113561900_B8","first-page":"357","article-title":"Capillary venous differences in neonatal neutrophil values","volume":"136","author":"Peevy","year":"1982","journal-title":"Am J Dis Child"},{"issue":"4","key":"2021121010113561900_B9","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1093\/ajcp\/72.4.608","article-title":"Pitfalls in the interpretation of leukocyte counts of newborn infants","volume":"72","author":"Christensen","year":"1979","journal-title":"Am J Clin Pathol"},{"issue":"1","key":"2021121010113561900_B10","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1046\/j.1365-2257.2003.00484.x","article-title":"Significant differences between capillary and venous complete blood counts in the neonatal period","volume":"25","author":"Kayiran","year":"2003","journal-title":"Clin Lab Haematol"},{"issue":"5","key":"2021121010113561900_B11","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1159\/000014107","article-title":"Leukocyte counts in relation to the method of delivery during the first five days of life","volume":"75","author":"Chirico","year":"1999","journal-title":"Biol Neonate"},{"issue":"4","key":"2021121010113561900_B12","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1038\/sj.jp.7211916","article-title":"Expected ranges for blood neutrophil concentrations of neonates: the Manroe and Mouzinho charts revisited","volume":"28","author":"Schmutz","year":"2008","journal-title":"J Perinatol"},{"issue":"2","key":"2021121010113561900_B13","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1093\/ajcp\/100.2.116","article-title":"Higher white blood cell counts and band forms in newborns delivered vaginally compared with those delivered by cesarean section","volume":"100","author":"Hasan","year":"1993","journal-title":"Am J Clin Pathol"},{"issue":"3","key":"2021121010113561900_B14","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1016\/S0022-3476(85)80681-8","article-title":"Neonatal blood cell count in health and disease. II. Values for lymphocytes, monocytes, and eosinophils","volume":"106","author":"Weinberg","year":"1985","journal-title":"J Pediatr"},{"issue":"6","key":"2021121010113561900_B15","doi-asserted-by":"crossref","first-page":"982","DOI":"10.1016\/S0022-3476(84)80095-5","article-title":"Neutropenia in high-risk neonates","volume":"105","author":"Engle","year":"1984","journal-title":"J Pediatr"},{"key":"2021121010113561900_B16","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1017\/CBO9780511759512.005","volume-title":"Evidence-Based Diagnosis","author":"Newman","year":"2009"},{"issue":"7","key":"2021121010113561900_B17","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/01.inf.0000131633.74921.90","article-title":"Trends in sepsis-related neonatal mortality in the United States, 1985\u20131998","volume":"23","author":"Lukacs","year":"2004","journal-title":"Pediatr Infect Dis J"},{"issue":"14","key":"2021121010113561900_B18","doi-asserted-by":"crossref","first-page":"1962","DOI":"10.1001\/jama.1992.03480140088039","article-title":"Rapid classification of positive blood cultures: prospective validation of a multivariate algorithm","volume":"267","author":"Bates","year":"1992","journal-title":"JAMA"},{"issue":"12","key":"2021121010113561900_B19","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/00006454-199012000-00006","article-title":"Changes in the differential white blood cell count in screening for group B streptococcal sepsis","volume":"9","author":"Greenberg","year":"1990","journal-title":"Pediatr Infect Dis J"},{"issue":"5","key":"2021121010113561900_B20","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1097\/00006454-198705000-00004","article-title":"Impaired sensitivity of a single early leukocyte count in screening for neonatal sepsis","volume":"6","author":"Rozycki","year":"1987","journal-title":"Pediatr Infect Dis J"},{"issue":"5","key":"2021121010113561900_B21","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1097\/01.inf.0000068206.11303.dd","article-title":"Utility of complete blood count and blood culture screening to diagnose neonatal sepsis in the asymptomatic at risk newborn","volume":"22","author":"Ottolini","year":"2003","journal-title":"Pediatr Infect Dis J"},{"issue":"3","key":"2021121010113561900_B22","first-page":"198","article-title":"Risk factors for early-onset group B streptococcal disease in neonates: a population-based case-control study","volume":"169","author":"Adair","year":"2003","journal-title":"CMAJ"},{"issue":"6","key":"2021121010113561900_B23","article-title":"Risk factors for early-onset group B streptococcal sepsis: estimation of odds ratios by critical literature review","volume":"103","author":"Benitz","year":"1999","journal-title":"Pediatrics"},{"issue":"7359","key":"2021121010113561900_B24","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1136\/bmj.325.7359.308","article-title":"Risk factors for early-onset neonatal group B streptococcal sepsis: case-control study","volume":"325","author":"Oddie","year":"2002","journal-title":"BMJ"},{"issue":"1 pt 1","key":"2021121010113561900_B25","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1542\/peds.105.1.21","article-title":"Risk factors and opportunities for prevention of early-onset neonatal sepsis: a multicenter case-control study","volume":"105","author":"Schuchat","year":"2000","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/126\/5\/903\/1055132\/zpe01110000903.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/126\/5\/903\/1055132\/zpe01110000903.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T22:34:16Z","timestamp":1639175656000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/126\/5\/903\/65310\/Interpreting-Complete-Blood-Counts-Soon-After"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11,1]]},"references-count":25,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2010,11,1]]},"published-print":{"date-parts":[[2010,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2010-0935","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11,1]]}}}