Nucleated red blood cells in growth-restricted fetuses: associations with short-term neonatal outcome.
OBJECTIVE
To determine the utility of the neonatal nucleated red blood cell (NRBC) count as an independent predictor of short-term perinatal outcome in growth-restricted fetuses.


METHODS
Hospital charts of neonates with a discharge diagnosis indicating a birth weight <10th percentile were reviewed for perinatal outcome. We studied all eligible neonates who had a complete blood count on the first day of life. After multiple gestations, anomalous fetuses and diabetic pregnancies were excluded; 73 neonates comprised the study group. Statistical analysis included ANOVA, simple and stepwise regression.


RESULTS
Elevated NRBC counts were significantly associated with cesarean section for non-reassuring fetal status, neonatal intensive care unit admission and duration of neonatal intensive care unit stay, respiratory distress and intubation, thrombocytopenia, hyperbilirubinemia, intraventricular hemorrhage and neonatal death. Stepwise regression analysis including gestational age at birth, birth weight and NRBC count demonstrated that in growth-restricted fetuses, NRBC count was the strongest predictor of neonatal intraventricular hemorrhage, neonatal respiratory distress and neonatal death.


CONCLUSIONS
An elevated NRBC count independently predicts adverse perinatal outcome in growth-restricted fetuses.
Minior
V K
VK
Department of Obstetrics and Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY, USA.
Bernstein
P S
PS
Divon
M Y
MY
D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section; D004900:Erythroblasts; D004906:Erythrocyte Count; D005260:Female; D005317:Fetal Growth Retardation / Q000097:blood*; D005865:Gestational Age; D006801:Humans; D006932:Hyperbilirubinemia / Q000097:blood; D007226:Infant Mortality; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D007440:Intubation; D011247:Pregnancy; D011379:Prognosis; D012044:Regression Analysis; D012127:Respiratory Distress Syndrome, Newborn / Q000097:blood; D018805:Sepsis / Q000097:blood