Dynamic trajectories of neonatal laboratory measurements in the first 26 weeks of life

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Abstract Laboratory measurements are vital for obtaining quantitative updates on patient’s health status. This study focused on analyzing 1173 distinct types of laboratory measurements collected from 34,605 infants, including ~12% born preterm (<37 weeks gestation) and ~88% born term admitted to the Stanford Children’s Hospitals utilizing electronic health records spanning from birth to 26 weeks of age. Our objective was to uncover temporal patterns and interdependencies among the measurements to characterize longitudinal laboratory trajectories during early infancy and identify potential biomarkers during this critical window of neonatal care. Correlation networks were constructed, revealing clustering patterns within the measurements. Notably, a distinct trend was observed in neutrophil counts, exhibiting a decreasing trend until around 12 weeks, followed by a subsequent increase until 26 weeks. This inflection point may reflect a transition phase in early immune system maturation beyond the immediate neonatal period, a stage that remains relatively under characterized in clinical studies. This significant observation was validated with the de-identified laboratory measurements recorded for 10,765 infants admitted in UCSF Benioff’s Hospital. Further, we explored the underlying potential clinical factors associated with the observed trend and found a significant association between observed white blood cell counts and the Phecode category, which includes congenital heart diseases (CHD). This data-driven analysis provides insights into immune trajectories during early infancy [ https://neonatesmeasures2025.streamlit.app/ ] highlighting the potential for applying data analytics for prognosis and early medical interventions.

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