Nucleated red blood cell count at birth as an index of perinatal brain damage.
OBJECTIVE
The prognostic value of the nucleated red blood cell count at birth with respect to perinatal brain damage and neonatal outcome was assessed in infants at high risk of having neurologic damage.


METHODS
The nucleated red blood cell count at birth, pulsed Doppler ultrasonography in the cerebral arteries, cranial fontanelle sonograms, and neurodevelopmental status were evaluated in 337 newborn infants.


RESULTS
The nucleated red blood cell count at birth was significantly higher (1) in neonates with abnormal Doppler ultrasonographic parameters for the cerebral arteries at 48 to 72 hours after birth than in healthy neonates, (2) in 6-month-old infants with sequelae of hypoxic-ischemic encephalopathy than in healthy infants, and (3) in 3-year-old children with abnormal developmental status than in those with no abnormalities at follow-up. Significant correlations were observed between the nucleated red blood cell count and gestational age, Apgar score at 1 and 5 minutes, pH, base deficit, fraction of inspired oxygen, blood oxygen content, and birth weight.


CONCLUSIONS
The nucleated red blood cell count at birth not only reflects a response of the infant to perinatal hypoxia but is also a reliable index of perinatal brain damage.
Buonocore
G
G
Institute of Preventive Paediatrics and Neonatology, University of Siena, Italy.
Perrone
S
S
Gioia
D
D
Gatti
M G
MG
Massafra
C
C
Agosta
R
R
Bracci
R
R
D001034:Apgar Score; D001930:Brain Injuries / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002536:Cerebral Arteries / Q000000981:diagnostic imaging*; D002658:Developmental Disabilities / Q000175:diagnosis*; D004900:Erythroblasts / Q000473:pathology*; D004906:Erythrocyte Count; D005260:Female; D006340:Heart Rate, Fetal; D006801:Humans; D000860:Hypoxia / Q000097:blood*; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging; D008297:Male; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D018617:Ultrasonography, Doppler, Pulsed