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Access through your institution Buy or subscribe We previously reported high fragmented red cell (FRC) counts from neonates with necrotizing enterocolitis (NEC), infection, or iron

deficiency [1, 2]. The FRC count is an automated quantification of red blood cells (RBC) smaller than those populating the RBC size-gate. RBC species within the FRC gate include

schistocytes, created when RBC circulate through areas where the endothelium is damaged and intraluminal fibrin strands cause red cells to become tethered and torn [1,2,3,4]. Abnormally

small RBC (microcytes) also appear in the FRC gate. These are created during iron deficiency, alpha thalassemia, or hereditary spherocytosis (HS) [1,2,3,4]. Because of heterogeneity of the

RBC species comprising the FRC count, an elevated FRC count would not be specific for diagnosing NEC. However, among neonates with a new-onset gastrointestinal (GI) problem, a high FRC count

might indicate NEC or infection or iron deficiency, while a normal count might indicate a non-inflammatory GI problem (e.g. feeding intolerance). We retrospectively assessed FRC counts of

neonates with a new-onset GI problem where a CBC, blood culture, and abdominal x-rays were ordered. This is a preview of subscription content, access via your institution ACCESS OPTIONS

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institutional subscriptions * Read our FAQs * Contact customer support DATA AVAILABILITY The data used in this study are available upon request from the corresponding author. REFERENCES *

Judkins AJ, MacQueen BC, Christensen RD, Henry E, Snow GL, Bennett ST. Automated quantification of fragmented red blood cells: neonatal reference intervals and clinical disorders of neonatal

intensive care unit patients with high values. Neonatology. 2019;115:5–12. Article  PubMed  Google Scholar  * Bahr TM, Judkins AJ, Christensen RD, Baer VL, Henry E, Minton SD, et al.

Neonates with suspected microangiopathic disorders: performance of standard manual schistocyte enumeration _vs_. the automated fragmented red cell count. J Perinatol. 2019;39:1555–61.

Article  PubMed  Google Scholar  * Bahr TM, Judkins AJ, Baer VL, Henry E, Grubb PH, Hulse W. The fragmented red cell count can support the diagnosis of a microangiopathic neonatal condition.

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2021;43:1264–71. Article  PubMed  Google Scholar  * Kim JH, Abrams SA. Neonatal necrotizing enterocolitis: clinical features and diagnosis. UpToDate; 2022. Download references

ACKNOWLEDGEMENTS The authors thank Molly Adams and Jillyn Spencer, Intermountain Healthcare Women and Newborn Research Department, for assistance with Institutional Review Board

communications. We also thank Shelby Moench, System Director, Human Research Protections Program, Intermountain Institutional Review Board. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS *

Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA Timothy M. Bahr, Allison J. Judkins, Shelley M. Lawrence, Robin K. Ohls & Robert D.

Christensen * Obstetric and Neonatal Operations, Intermountain Healthcare, Salt Lake City, UT, USA Timothy M. Bahr, Erick Henry & Robert D. Christensen * Student, University of Utah,

Salt Lake City, UT, USA Thomas R. Christensen * Intermountain Healthcare Central Laboratory, Intermountain Medical Center, Murray, UT, USA Sterling T. Bennett * Intermountain Healthcare,

Primary Children’s Hospital Salt Lake City, Salt Lake City, UT, USA Theodore J. Pysher * Department of Pathology, University of Utah, Salt Lake City, UT, USA Sterling T. Bennett & 

Theodore J. Pysher Authors * Timothy M. Bahr View author publications You can also search for this author inPubMed Google Scholar * Thomas R. Christensen View author publications You can

also search for this author inPubMed Google Scholar * Erick Henry View author publications You can also search for this author inPubMed Google Scholar * Allison J. Judkins View author

publications You can also search for this author inPubMed Google Scholar * Sterling T. Bennett View author publications You can also search for this author inPubMed Google Scholar * Theodore

J. Pysher View author publications You can also search for this author inPubMed Google Scholar * Shelley M. Lawrence View author publications You can also search for this author inPubMed 

Google Scholar * Robin K. Ohls View author publications You can also search for this author inPubMed Google Scholar * Robert D. Christensen View author publications You can also search for

this author inPubMed Google Scholar CONTRIBUTIONS All authors listed met criteria for authorship. TMB, TRC, EH, and RDC contributed to the design and data collection. All authors, including

AJJ, STB, TGP, SML, and RKO, contributed to writing and editing the manuscript and all approved the final draft. CORRESPONDING AUTHOR Correspondence to Timothy M. Bahr. ETHICS DECLARATIONS

COMPETING INTERESTS The authors declare no competing interests. ETHICAL APPROVAL The Institutional Review Board of Intermountain Healthcare judged this to be exempt from the need for

individual informed consent. They reviewed this manuscript prior to submission for publication and judged it compliant with institutional privacy-protection policies. ADDITIONAL INFORMATION

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manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Bahr, T.M.,

Christensen, T.R., Henry, E. _et al._ Fragmented red blood cell counts of neonates with new-onset gastrointestinal disturbances. _J Perinatol_ 43, 1173–1175 (2023).

https://doi.org/10.1038/s41372-022-01587-z Download citation * Received: 12 October 2022 * Revised: 10 December 2022 * Accepted: 13 December 2022 * Published: 26 December 2022 * Issue Date:

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