Neonatal biochemical reference ranges





Ruth M Ayling
Ann Bowron



Table A6.1

Plasma/serum


















































































































































































































































































































































































































































































































































































































































































































































































































































































































































ANALYTE UNIT REFERENCE RANGE COMMENT
Preterm Term
Gestational age (weeks) Age Reference range Age Reference range
Alanine aminotransferase (ALT) ( ) IU/l M F Range dependent on methodology
1–7 d 6–40 7–40
8–30 d 10–40 8–32
Albumin ( ; ) g/l 27 21–33 M F
29 23–34 1–7 d 24–39 19–40
31 22–35 8–30 d 21–45 19–44
33 22–35
35 22–36
Alkaline phosphatase (ALP) ( ) IU/l M F Range dependent on methodology
1–7 d 107–357
8–30 d 107–474
α 1 -antitrypsin ( ) g/l 0–30 d 0.79–2.23 ‘Adult’ concentrations at birth, falling after 2 weeks. To assess possible deficiency, phenotype should be determined
α-fetoprotein (AFP) ( ) U/ml Birth 7533–157 390 Range dependent on methodology
Higher in premature babies
Half-life 5.1 days
1 d 6561–137 082
2 d 5741–119 393
3 d 4977–103 988
4 d 4375–90 569
5 d 3819–79 796
6 d 3335–69 660
7 d 2911–60 811
8–14 d 1222–48 640
15–21 d 475–18 924
22–28 d 261–5212
Aldosterone ( ) ng/dL 26–28 4 d 5–635 3 d 7–184
31–35 4 d 19–141 1 w 5–175
1 m 5–90
Aluminium ( ) µmol/l 0.07–0.80
Ammonia ( ) µmol/l 0–30 d 21–95 Preterm and/or sick babies may have concentrations up to 200 µmol/l
Amylase ( ) IU/l 0–30 d <30 Range dependent on methodology
Androstenedione ( ) nmol/l M F
0 d 1.47–13 0.8–12
15 d 1.0–8.7 0.7–7.9
30 d 0.6–5.9 0.5–5.3
Aspartate transaminase (AST) ( ) IU/l M F Range dependent on methodology
1–7 d 26–98 20–93
8–30 d 16–67 20–69
Bilirubin ( ) µmol/l Birth–1 d <100 Refer to neonatal treatment charts for further details
<140
1–2 d <200
Total 3–5 d
Conjugated 0–30 d <10
Caeruloplasmin ( ) mg/l M F Increases from birth throughout first year
1–30 d 77–253 33–275
Calcium mmol/l M F Results should be interpreted in conjunction with serum albumin concentration
Total ( ; ) 21–28 2.14–2.65 0–7 d 1.83–2.85 1.88–2.83
8–30 d 2.15–2.93 2.10–2.98
1.05–1.37
1.10–1.44
1.20–1.48
Ionised ( ; ) mmol/l 25–36 1 d 0.81–1.41 1 d
2 d 0.72–1.44 3 d
3 d 1.04–1.52 5 d
Chloride ( ) mmol/l 0–30 d 97–108
Cholesterol ( ) mmol/l M F Gradual increase from birth
1–30 d 1.4–3.9 1.6–4.0
Copper ( ) µmol/l 28–34 3.0–8.3 0–5 d 1.4–7.2 Rapid increase during first week
5–28 d 4.0–11.0
Cortisol ( ; ) mmol/l 24 0–14 d 73–562 0 d 54–839 If there is doubt about the integrity of the hypothalamo-pituitary adrenal axis, a short Synacthen test should be performed
3 d 54–814
15 d 54–728
30 d 55–645
C-reactive protein (CRP) ( ) mg/l <16
Creatine kinase (CK) ( ) IU/l Cord blood 70–380 Range dependent on methodology
5–8 h 214–1175
24–33 h 130–1200
72–100 h 87–725
Creatinine ( ; ; ) µmol/l 24–28 1 d 35–136 2 d 37–113 Creatinine rises in the first 48 h, especially in infants <30 weeks’ gestation ( )
29–36 1 d 27–175 7 d 14–86
26–34 1 w 69–141 14 d 18–58
2 w 45–99 21 d 15–55
3–4 w 39–71 28 d 12–48
5–6 w 42–62
7–9 w 39–48
Cystatin C ( ) mg/l 24–28 0.65–3.37 0–28 d 0.81–2.32
29–36 0.62–4.42
Dehydroepiandrosterone sulphate (DHEAS) ( ) µmol/l M F
0 d 0.7–8.9 0.8–10
3 d 0.7–8.4 0.9–9.6
15 d 0.6–6.6 0.7–8.1
30 d 0.5–4.8 0.6–6.3
Ferritin ( ) µg/l M F
1–30 d 36–381 36–483
Glucose ( ) mmol/l 1–7 d 2.71–6.11
8–30 d 3.00–6.49
γ-Glutamyltransferase (GGT) ( ) IU/l 1–7 d 18–148 Results depend on methodology
8–30 d 16–140
17α-Hydroxyprogesterone (17-OHP) ( ) nmol/l 0 d 17.2–252 Premature and/or sick infants may have concentrations 2–3-fold higher
3 d 9.9–33.1
15 d 8.8–29.2
30 d 7.4–24.5
Immunoglobulins ( ) M F Lower in premature infants
IgG g/l 1–30 d 2.21–8.38 1.88–8.76
IgA g/l 0.01–0.17 0.01–0.16
IgM g/l 0.08–0.78 0.13–0.70
IgD mg/l none detected
IgE kIU/l 0–12 m 2–24 0–20
Immunoreactive trypsin ( ) µg/l <60 Blood spot
Insulin Should be measured during documented hypoglycaemia. There may be cross-reactivity with proinsulins and values may be higher in premature infants, hence results should always be interpreted in light of clinical features and intravenous glucose requirements
Insulin-like growth factor-1 (IGF-1) ( ) ng/ml 0 d 22.8–100.9
1–30 d 7–92
Insulin-like growth factor binding protein-3 (IGFBP-3) ( ) mg/l 0–1 w 0.42–1.39
1–4 w 0.77–2.09
Iron ( ) µmol/l M F
0–30 d 5.7–20.0 5.2–22.7
Lactate ( ) mmol/l 0–90 d 1.0–3.5
Lactate dehydrogenase (LDH) ( ) U/l M F Results depend on methodology
1–30 d 178–629 187–600
1–3 m 158–373 152–353
Magnesium ( ; ) mmol/l 25–36 1 d 0.62–1.02 1 d 0.72–1.00
3 d 0.66–1.10 3 d 0.81–1.05
5 d 0.68–1.24 5 d 0.78–1.02
7–28 d 0.75–1.00 7–28 d 0.65–1.00
Manganese ( ) nmol/l >360 Risk of toxicity
Non-esterified fatty acids ( ) mmol/l 26–36 3 d 0.01–1.04 3 d 0.04–1.34
Osmolality ( ) mosmol/kg Birth 275–300 275–295
7 d 276–305
28 d 274–305
Phenylalanine ( ) µmol/l 98–213 38–137
Phosphate ( ) mmol/l 2–3 d 1.81–3.00 Tends to be higher in babies fed formula milk
3–4 d 1.74–2.76
4–6 d 1.64–2.70
6–12 d 1.39–3.03
21 d 1.74–2.66
Potassium ( ; ) mmol/l 7 d 4.6–6.7 0–1 w 3.2–5.7 Results from capillary blood tend to be higher. Serum potassium concentrations are higher than those of plasma due to potassium released from platelets during clotting
1 w–1 m 3.4–6.2
Prolactin ( ) mU/l 0–30 d 9–2850 May be considerably higher in the first 2 weeks
Protein ( ; ) (total) g/l 22–36 36–63 1–30 d 41–63
Pyruvate ( ) µmol/l 1–30 d 80–150
Selenium ( ) µmol/l 0–4 w 0.19–1.35
Sodium ( ) mmol/l 0–7 d 131–144
7–31 d 132–142
Testosterone ( ) nmol/l M F M F
26–28 4 d 2.1–4.4 0.18–0.6 2.6–14 0.7–2.2
31–35 4 d 1.3–6.9 0.18–0.8
Thyroid-stimulating hormone (TSH) ( ; ; ) mU/l 28–40 >7 d 0.8–12.0 1 d 3.0–120 Rapid increase during the first 24 h
2 d 3.0–30
3–30 d 0.5–6.0
Thyroxine ( ; ) free (FT 4 ) pmol/l 25–30 0–7 6.4–42.5 1–3 d 25.7–68.2
31–36 0–7 16.7–60.6 1–4 w
Triiodothyronine ( ; ; ) free (FT 3 ) pmol/l 29–36 1–3 d 1.2–7.3 1–3 d 2.5–9.3 Lower in small sick infants
4–10 d 1.2–4.9 4–10 d 2.8–5.7
Triglyceride ( ) mmol/l M F
0–7 d 0.24–2.06 0.32–1.88
8–30 d 0.34–2.08 0.34–1.86
Urate ( ) µmol/l 0–1 d 300–505
1–2 d 200–490
2–3 d 190–395
3–7 d 150–290
Urea ( ) mmol/l 1–7 d 0.7–4.6 May be higher in infants fed formula milk
8–30 d 0.7–5.7
Zinc ( ; Lockitch et al. 1998) µmol/l 28–34 10–24 0–5 d 9.9–21.4 Higher in preterms. Concentration decreases during first week

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Apr 21, 2019 | Posted by in PEDIATRICS | Comments Off on Neonatal biochemical reference ranges

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